黑龙江省大兴安岭地区宫颈癌筛查方案的成本-效果分析
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摘要
目的:对宫颈癌多种筛查方案的效果进行卫生经济学评价,并探讨最具有成本-效果的筛查方案。方法:选取黑龙江省大兴安岭地区35～64岁的3 500名适龄农村妇女进行液基细胞学检测、细胞DNA定量分析方法及人乳头瘤病毒(HPV)DNA检测3种筛查方法的检测,对单一使用以及每两种筛查方法联合的几种方案分别进行卫生经济学效果分析。结果:应用细胞DNA定量分析方法筛查成果-效果比最佳,HPV联合细胞DNA定量分析方法宫颈病变检出率最高。结论:农村妇女宫颈癌筛查采用单一技术方案——细胞DNA定量分析法是最具成果-效果的筛查方案。
Objective: To conduct the health economics evaluation on the effectiveness of various screening strategies for cervical cancer, and to explore the optimized cost-effective screening program. Methods: A total of 3 500 women aged 35-64 years old from Greater Khingan Mountains were involved. Cervical sample were taken to screen by TCT, DNA quantitative analysis and detection of human papillomavirus(HPV) DNA. The effects of health economics on the single use and each of the two screening methods were analyzed respectively. Results: The application of DNA quantitative analysis could lead the best result. The method of HPV combined with DNA quantitative analysis could screen the highest lesions detection rate. Conclusion: DNA quantitative analysis was the optimized cost-effectiveness screen program for women in rural areas based on single technical program.
Objective: To conduct the health economics evaluation on the effectiveness of various screening strategies for cervical cancer, and to explore the optimized cost-effective screening program. Methods: A total of 3 500 women aged 35-64 years old from Greater Khingan Mountains were involved. Cervical sample were taken to screen by TCT, DNA quantitative analysis and detection of human papillomavirus(HPV) DNA. The effects of health economics on the single use and each of the two screening methods were analyzed respectively. Results: The application of DNA quantitative analysis could lead the best result. The method of HPV combined with DNA quantitative analysis could screen the highest lesions detection rate. Conclusion: DNA quantitative analysis was the optimized cost-effectiveness screen program for women in rural areas based on single technical program.
引文
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[2]姜淑清,王涛,土送爱,等.新疆策勒县官颈癌的流行病学调查研究[J].中国实用妇科与产科杂志,2006,22(5):379-381.
[3]LIU S,SEMENCIW R,PROBERT A,et al.Cervical cancer in Canada:changing patterns in incidence and mortality[J].Int j gynecol cancer,2001,11(1):24-31.
[4]黄恩杰,罗新.中国大陆宫颈细胞学筛查技术实施的现状及缺憾[J].中国计划生育和妇产科,2016,8(9):4-7.
[5]PAN Qin-jing,HU Shang-ying,GUO Hui-qin,et al.Liquid based cytology and human papillomavirus testing:a pooled analysis using the data from 13 population-based cervical cancer screening studies from China[J].Gynecol oncol,2014,133(2):172-179.
[6]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志,2015,11(2):1-6.
[7]GARNER D.Clinical application of DNA ploidy to cervical cancer screening:a review[J].World j clin oncol,2014,5(5):931-965.
[8]PARTRIDGE E E,ABU-RUSTUM N,GIULIAONO A,et al.Cervical cancer screening[J].J natl compr canc netw,2014,12(3):333-341.