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首页> 外文期刊>Best practice & research:Clinical obstetrics & gynaecology >Health economics of screening for gynaecological cancers
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Health economics of screening for gynaecological cancers

机译：妇科癌症筛查的健康经济学

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In this chapter, we summarise findings from recent cost-effectiveness analyses of screening for cervical cancer and ovarian cancer. We begin with a brief summary of key issues that affect the cost-effectiveness of screening, including disease burden, and availability and type of screening tests. For cervical cancer, we discuss the potential effect of human papilloma virus vaccines on screening. Outstanding epidemiological and cost-effectiveness issues are included. For cervical cancer, this includes incorporating the long-term effect of treatment (including adverse birth outcomes in treated women who are of reproductive age) into cost-effectiveness models using newly available trial data to identify the best strategy for incorporating human papilloma virus tests. A second issue is the need for additional data on human papilloma virus vaccines, such as effectiveness of reduced cancer incidence and mortality, effectiveness in previously exposed women and coverage. Definitive data on these parameters will allow us to update model-based analyses to include more realistic estimates, and also potentially dramatically alter our approach to screening. For ovarian cancer, outstanding issues include confirming within the context of a trial that screening is effective for reducing mortality and incorporating tests with high specificity into screening into screening algorithms for ovarian cancer.
机译：在本章中，我们总结了近期筛查宫颈癌和卵巢癌的成本效益分析的发现。我们首先简要概述影响筛查成本效益的关键问题，包括疾病负担，筛查试验的可用性和类型。对于宫颈癌，我们讨论了人类乳头瘤病毒疫苗对筛查的潜在影响。其中包括未解决的流行病学和成本效益问题。对于宫颈癌，这包括将治疗的长期效果（包括生育年龄的受治疗妇女的不良出生结局）纳入成本效益模型，并使用新近获得的试验数据来确定纳入人类乳头瘤病毒测试的最佳策略。第二个问题是需要有关人乳头瘤病毒疫苗的其他数据，例如降低癌症发病率和死亡率的有效性，以前接触过的妇女的有效性以及覆盖率。这些参数的权威数据将使我们能够更新基于模型的分析，以包括更切合实际的估计，并且还可能显着改变我们的筛查方法。对于卵巢癌，悬而未决的问题包括在试验范围内确认筛查可有效降低死亡率，并将高特异性的检测方法纳入筛查卵巢癌的筛查算法中。

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