Cost-effectiveness analysis of esophageal cancer once-in-a-lifetime endoscopic screening in high-risk areas of rural China
10.3760/cma.j.issn.0253-3766.2015.06.017
- VernacularTitle:中国农村食管癌高发区人群终生一次内镜筛查适宜年龄的卫生经济学评价
- Author:
Hao FENG
1
;
Guohui SONG
;
Juan YANG
;
Changqing HAO
;
Meng WANG
;
Bianyun LI
;
Deli ZHAO
;
Zhicai LIU
;
Wenqiang WEI
;
Youlin QIAO
Author Information
1. 100021,北京协和医学院 中国医学科学院肿瘤医院流行病学研究室
- Keywords:
Esophageal neoplasms;
Endoscopy;
Screening;
Cost-effectiveness analysis
- From:
Chinese Journal of Oncology
2015;(6):476-480
- CountryChina
- Language:Chinese
-
Abstract:
Objective To estimate the cost?effectiveness of esophageal cancer endoscopic screening once?in?a?lifetime and to predict the optimal screening age for people in high?risk areas of rural China. Methods A Markov model was constructed to predict and compare the effect of four esophageal cancer endoscopic screening modalities which varied with different screening ages. Long?term epidemiological effectiveness and cost?effectiveness were predicted by simulation of the model. Results Compared with the control group, strategies starting at 40, 45, 50 and 55 year?old had saved life?years of 629. 51, 769. 88, 738.98 and 533. 21 years per 100 000 people, respectively, of which the strategy starting at 45 year?old saved the maximum life years. All strategies were cost?effective and starting at 40 year?old cost the most per life?year saved. Among all alternatives, strategies starting age at 45 year?old and 50 year?old were incremental cost?effective, and the incremental cost?effective ratios were 34 962.87 and 3 346.43 RMB per life year saved, respectively. Conclusions The strategy starting at 40 year?old implemented at present and other strategies were cost?effective in high?risk areas of rural China. However, the 45?year?old group is more aligned with the principle of cost?effectiveness. Considering the cost?effectiveness of different strategies and social economic status, 45 year?old is regarded as the optimal starting age of esophageal cancer once?in?a?lifetime endoscopic screening and is recommended in areas lacking health resources. The strategy of starting age at 40 year?old which could obtain better screening effects would be preferable in wealthy regions.
