CAJ | 학술논문

目的：评价社区人群结直肠癌机会性筛查的成本效果。方法对2013年4—7月在中国航天科工集团七三一医院体检中心进行健康体检的某单位在职及退休职工5270名进行结直肠癌机会性筛查，测算筛查成本和效果，进行成本效果分析。结果初筛人群中，结直肠肿瘤危险因素量表调查问卷（ QA ）顺应性为100.00％（5270/5270），阳性率为11.95％（630/5270）；免疫法粪便隐血试验（IFOBT）顺应性为83.91％（4422/5270），阳性率为2.28％（101/4422）；共筛查出666例高危人群（QA和IFOBT任意一项阳性者），阳性率为12.64％（666/5270）。高危人群中，有202例接受了结肠镜检查，顺应性为30.33％（202/666）。结肠镜检查发现结直肠癌3例，检出率为1.49％（3/202）；癌前病变（腺瘤性息肉）45例，检出率为22.28％（45/202）。初筛出1例高危人群的平均成本为55.95元，筛查出1例癌前病变的平均成本为2612.88元，筛查出1例结直肠癌的平均成本为39193.13元。结论社区人群结直肠癌机会性筛查顺应性好，是经济和有效的，适合大范围推广。
목적：평개사구인군결직장암궤회성사사적성본효과。방법대2013년4—7월재중국항천과공집단칠삼일의원체검중심진행건강체검적모단위재직급퇴휴직공5270명진행결직장암궤회성사사，측산사사성본화효과，진행성본효과분석。결과초사인군중，결직장종류위험인소량표조사문권（ QA ）순응성위100.00％（5270/5270），양성솔위11.95％（630/5270）；면역법분편은혈시험（IFOBT）순응성위83.91％（4422/5270），양성솔위2.28％（101/4422）；공사사출666례고위인군（QA화IFOBT임의일항양성자），양성솔위12.64％（666/5270）。고위인군중，유202례접수료결장경검사，순응성위30.33％（202/666）。결장경검사발현결직장암3례，검출솔위1.49％（3/202）；암전병변（선류성식육）45례，검출솔위22.28％（45/202）。초사출1례고위인군적평균성본위55.95원，사사출1례암전병변적평균성본위2612.88원，사사출1례결직장암적평균성본위39193.13원。결론사구인군결직장암궤회성사사순응성호，시경제화유효적，괄합대범위추엄。
Objective To evaluate the cost effectiveness of opportunistic screening for colorectal cancer in community population. Methods From April to July in 2013,we conducted opportunistic screening for colorectal cancer on 5 270 in -service or retired staffs of an institution who received physical examination in No. 731 Hospital of CASIC. The cost and effectiveness of screening was measured,and cost -effectiveness analysis was conducted. Results Among the subjects,the compliance to colorectal cancer risk factor scale ( QA ) was 100. 00%( 5 270/5 270 ), and the positive rate was 11. 95%(630/5 270);the compliance to immune fecal occult blood test(IFOBT)was 83. 91%(4 422/5 270),and the positive rate was 2. 28%(101/4 422);a total of 666 subjects with high risk for colorectal cancer were found(with either QA positive or IFOBT positive),and the positive rate was 12. 64% (666 /5 270). Among high - risk subjects,202 subjects received colonoscopy examination with a compliance of 30. 33% ( 202/666 ). We found 3 cases of colorectal cancer by colonoscopy examination,with a detection rate of 1. 49%(3 /202);we detected 45 cases of precancerous lesions(adenomatous polyp)with an detection rate of 22. 28%( 45/202 ) . The average screening cost for one case of high risk for colorectal cancer was 55. 95 yuan,the average screening cost for one case of precancerous lesions was 2 612. 88 yuan,and the average cost for one case of colorectal cancer was 39 193. 13 yuan. Conclusion The opportunistic screening for colorectal cancer in community population is effective and economical with high screening compliance,thus it is suitable for widespread promotion.