胃癌筛查卫生经济学评价的系统评价

Health economics evaluation of gastric cancer prevention and screening:a systematic review

目的系统评价国内外胃癌筛查的卫生经济学评价研究现状。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、WanFang Data和VIP数据库,搜集关于胃癌筛查的卫生经济学评价研究,检索时限为1975年1月1日至2021年9月30日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,进行定性分析。结果最终纳入44个研究。研究的目标人群多数为胃癌高发地区的高危人群。研究内容主要评价内镜、幽门螺杆菌感染检测等筛查方法,约47%的研究评估了单个筛查方法的经济性。共35个研究建立了卫生经济学模型,但仅少数研究对模型进行校准。结论我国胃癌筛查卫生经济学评价研究还存在模型未考虑吸烟的影响、未进行模型校准、评价方案较局限等问题。

Objective To systematically review the current situation of health economics evaluation of gastric cancer screening.Methods The PubMed,EMbase,The Cochrane Library,Web of Science,CNKI,WanFang Data and VIP databases were electronically searched to collect the health economics evaluation studies on gastric cancer screening from January 1st,1975 to September 30th,2021.Two reviewers independently screened the literature,extracted data and assessed the risk of bias of the included studies.Then,qualitative analysis was performed.Results A total of 44 studies were included.Most of the targeted populations of the study were high-risk groups in areas with a high incidence of gastric cancer.Screening methods such as endoscopy and Helicobacter pylori infection detection were mainly evaluated in those studies.According to the results,about 47%of the studies evaluated a single screening method.A total of 35 studies showed that they established models,however,only a few calibrated the models.Conclusion Most studies of gastric cancer screening reviews neither calibrate the results nor consider the effect of smoking on the progression of gastric cancer.Those evaluated screening programs are limited.