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首页> 外文期刊>Urologic oncology >Should we screen for bladder cancer in a high-risk population? A cost per life-year saved analysis Lotan Y, Svatek RS, Sagalowsky AI, Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
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Should we screen for bladder cancer in a high-risk population? A cost per life-year saved analysis Lotan Y, Svatek RS, Sagalowsky AI, Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.

机译：我们应该在高危人群中筛查膀胱癌吗？每生命年节省的成本分析Lotan Y，Svatek RS，Sagalowsky AI，德克萨斯大学西南医学中心（德克萨斯州达拉斯）泌尿外科。

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BACKGROUND: The U.S. Food and Drug Administration recently approved screening high-risk patients for bladder cancer using urine-based markers. The cost and life-years saved associated with bladder cancer screening were evaluated. METHODS: A Markov model was created to estimate cumulative cancer-related costs and efficacy of screening (vs. no screening) of a high-risk population for bladder cancer using a urine-based tumor marker over a 5-year period. Assumptions were based on literature review of survival and progression rates for patients with bladder cancer and costs associated with different bladder cancer disease states. RESULTS: Screening for bladder cancer in a population with a 4% incidence of bladder cancer resulted in a gain of 3.0 life years per 1000 subjects at a cost savings of Dollars 101,000 for the population, assuming a 50% downstaging in the screened population from muscle-invasive to nonmuscle-invasive disease. One-way sensitivity analyses found that screening is the most cost-effective strategy if cancer incidence is >1.6%, tumor marker costs 26%, marker specificity is >54%, downstaging with screening is >20%, and office cystoscopy costs
机译：背景：美国食品药品监督管理局最近批准了使用尿液标记物筛查高危患者的膀胱癌。评估与膀胱癌筛查有关的成本和挽救的生命年。方法：建立了一个马尔可夫模型，以估计在五年内使用尿液肿瘤标记物对与癌症相关的累积成本和筛查（相对于无筛查）膀胱癌高风险人群的有效性。假设是基于文献回顾性膀胱癌患者的生存和进展率以及与不同膀胱癌疾病状态相关的费用。结果：在罹患膀胱癌的4％人群中进行膀胱癌筛查，每千名受试者可获得3.0个生命年，并且为该人群节省了101,000美元的成本，前提是被筛查人群的肌肉下降了50％ -侵入性至非肌肉侵入性疾病。单向敏感性分析发现，如果癌症发生率> 1.6％，肿瘤标志物成本 26％，标志物特异性> 54％，筛查降级> 20，筛查是最具成本效益的策略百分比和办公室膀胱镜检查费用<694美元。膀胱切除术，经尿道膀胱肿瘤切除术（TURBT），化学疗法，临终护理，转移性疾病的费用以及计算机X线断层扫描的费用各不相同筛选的优势。结论：该模型发现基于尿液的标记物在高危人群中具有成本效益。在建议进行膀胱癌筛查之前，应进行完全无症状高危队列的前瞻性随机试验。

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