PLoS One:使用Stockholm3测试进行前列腺癌筛查的成本效益分析

2021-03-16 AlexYang MedSci原创

欧洲前列腺癌筛查随机研究发现前列腺特异性抗原(PSA)筛查可降低前列腺癌死亡率,然而筛查的成本和危害可能超过死亡率的降低效果。与单独使用PSA测试进行筛查相比,使用Stockholm3模型(S3M)作

欧洲前列腺癌筛查随机研究发现前列腺特异性抗原(PSA)筛查可降低前列腺癌死亡率,然而筛查的成本和危害可能超过死亡率的降低效果。与单独使用PSA测试进行筛查相比,使用Stockholm3模型(S3M)作为PSA≥1 ng/mL的反射测试对Gleason评分≥7的癌症具有相同的敏感性,而Gleason评分6癌症和无癌症的相对阳性率分别为0.83和0.56。到目前尚未对S3M测试的成本效益进行评估

研究人员从终生的社会角度进行了成本效益分析,并使用微观模拟模型模拟了以下情况。(i)不进行前列腺癌筛查;(ii)使用PSA检测进行筛查;(iii)在PSA值≥1、1.5和2 ng/mL的情况下,使用S3M测试作为反射检测进行筛查。筛查策略包括由全科医生对55-69岁的人群进行四年一次的再检测。研究人员还计算了贴现成本、质量调整生命年(QALYs)和增量成本效益比(ICERs)。

结果表明,将反射阈值为2 ng/mL的S3M与使用PSA检测的筛查进行比较发现,S3M的有效性增加,终生活检次数减少30%,社会成本增加0.4%。相对于PSA检测,S3M反射阈值为1、1.5和2 ng/mL的ICER分别为17万、6万和6000欧元/QALY。在活检费用较高的情况下,S3M检测的性价比更高。

最后,研究人员指出,对起始PSA≥2.0 ng/mL的男性进行前列腺癌筛查时,使用S3M测试比单独使用PSA测试进行筛查更划算

原始出处:

Andreas A Karlsson, Shuang Hao, Alexandra Jauhiainen et al. The cost-effectiveness of prostate cancer screening using the Stockholm3 test. PLoS One. Feb 2021

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    2021-03-17 易水河

    学习学习了

    0

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    2021-03-17 misszhang

    前列腺癌相关研究,学习了,谢谢梅斯

    0

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