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首页> 外文期刊>International journal of colorectal disease. >Comparative effectiveness and cost-effectiveness analysis of a urine metabolomics test vs. alternative colorectal cancer screening strategies
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Comparative effectiveness and cost-effectiveness analysis of a urine metabolomics test vs. alternative colorectal cancer screening strategies

机译：尿代谢测验对比较有效性及成本效益分析与替代结直肠癌筛查策略

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Purpose Despite the success of provincial screening programs, colorectal cancer (CRC) is still the third most common cancer in Canada and the second most common cause of cancer-related death. Fecal-based tests, such as fecal occult blood test (FOBT) and fecal immunochemical test (FIT), form the foundation of the provincial CRC screening programs in Canada. However, those tests have low sensitivity for CRC precursors, adenomatous polyps and have low adherence. This study evaluated the effectiveness and cost-effectiveness of a new urine metabolomic-based test (UMT) that detects adenomatous polyps and CRC. Methods A Markov model was designed using data from the literature and provincial healthcare databases for Canadian at average risk for CRC; calibration was performed against statistics data. Screening strategies included the following: FOBT every year, FIT every year, colonoscopy every 10 years, and UMT every year. The costs, quality adjusted life years (QALY) gained, and incremental cost-effectiveness ratios (ICERs) for each strategy were estimated and compared. Results Compared with no screening, a UMT strategy reduced CRC mortality by 49.9% and gained 0.15 life years per person at $42,325/life year gained in the base case analysis. FOBT reduced CRC mortality by 14.9% and gained 0.04 life years per person at $25,011/life year gained. FIT reduced CRC mortality by 35.8% and gained 0.11 life years per person at $25,500/life year while colonoscopy reduced CRC mortality by 24.7% and gained 0.08 life years per person at $50,875/life year. Conclusions A UMT strategy might be a cost-effective strategy when used in programmatic CRC screening programs.
机译：目的尽管省级筛查计划的成功，结直肠癌（CRC）仍然是加拿大的第三次常见的癌症，以及癌症相关死亡的第二个最常见的原因。基于粪便的试验，如粪便潜血（FOBT）和粪便免疫化学测试（FIT），形成加拿大省级CRC筛选计划的基础。然而，这些测试对CRC前体，腺瘤性息肉具有低灵敏度，并且具有低粘附性。该研究评估了检测腺瘤息肉和CRC的新尿代谢物的试验（UMT）的有效性和成本效益。方法使用来自CRC的平均风险的文献和省级医疗保健数据库的数据和省级医疗数据库的数据设计了Markov模型;对统计数据进行校准。筛选策略包括：以下：每年费用，每年都满足每年10年的结肠镜检查，每年都有UMT。估计和比较了每种策略的成本，质量调整后的终身年（QALY）和每个策略的增量成本效益比率（ICERS）。结果与无筛查相比，UMT策略将CRC死亡率降低49.9％，每人每年增长0.15亿美元，终身年份在基本案例分析中获得的42,325美元。 FOBT将CRC死亡率降低14.9％，每人获得0.04亿美元，每年获得25,011美元/终身年度。拟定CRC死亡率降低了35.8％，每人获得0.11岁，每年达到25,500美元/终身年度，同时结肠镜检查将CRC死亡率降低24.7％，每人每人获得0.08亿美元，每年50,875美元。结论在编程CRC筛选计划中使用时，UMT策略可能是一种成本效益的策略。

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