高发区食管癌和癌前病变内镜普查方案的效益评估

Benefit Evaluation for Endoscopic Screening of Esophageal Cancer and its Precursors in High Risk Areas

目的:分析肥城市自愿参加碘染色内镜食管疾病普查和全人群高应答率普查两类资料,为进一步探讨在食管癌高发区开展碘染色内镜普查可滚动持续发展的模式提供基础。方法:自愿参加普查组普查免费、治疗自费,高应答率普查组普查费和治疗费用全免,分析两组人群的食管疾病检出率和成本效益比率。结果:自愿参加普查组总应答率22.10%,高应答率普查组为79.99%;自愿参加普查组食管疾病的检出率显著高于高应答率普查组,自愿参加普查组的成本效益比率为1.0∶5.7,高应答率普查组为1.0∶1.43。结论:自愿参加普查组成本效益比率远远高于高应答率普查组,如何筛选需要进行内镜普查的高危险性个体是需要解决的关键问题。

Objective：To analyze and compare the data of low-response group and high-response group of I-staining endoscopic screening for esophageal lesions in Feicheng,one high-risk area of esophageal cancer,and to provide basis for formulating a sustainable model of endoscopic staining examination in high-risk areas of esophageal cancer. Methods：The low-response groups were given free examination but paid for the treatment; the high-response groups were given free examination and treatment. The detection rate of esophageal lesions and cost-benefit ratio were compared among the low groups. Results：The response rates were 22.10% and 79.99% in low and high response groups respectively. The detection rate of esophageal lesions in low response group was significantly higher than in high response group. The cost-benefit ratios were 1.0∶5.7 and 1.0∶1.43 in low and high response groups respectively. Conclu-sions：The cost-benefit ratio in low response groups is significantly higher than in high response groups. It needs further study on how to screen the risk individuals who need endoscope examination.