@文章{信息:doi/10.2196/36425，作者="赵子璇杜子璇李凌斌王媛媛王乐王幼青杨毅董恒进"，标题="基于起始年龄和间隔的低剂量ct肺癌筛查的成本-效果:建模研究"，期刊="JMIR公共卫生监测"，年="2022"，月="7月"，日="6"，卷="8"，数="7"，页数="e36425"，关键词="成本-效果分析;低剂量计算机断层扫描;筛选;肺癌;背景:肺癌是中国最常见的癌症，也是癌症相关死亡的主要原因。据报道，肺癌筛查的有效性可以降低肺癌特异性和总体死亡率，尽管成本效益、最佳开始年龄和筛查间隔尚不清楚。目的:本研究旨在评估中国重度吸烟者肺癌筛查的成本效益，包括开始年龄和筛查间隔时间。方法:采用马尔可夫状态转换模型评估中国肺癌筛查项目的成本效益。评估的筛查策略基于筛查开始年龄为50-74岁，筛查间隔时间为一次或一年。转移概率从文献中获得并验证，而成本参数来自当地医疗保险局的数据库。 A societal perspective was adopted. The outputs of the model included costs, quality-adjusted life years (QALYs), and lung cancer--specific mortality, with future costs and outcomes discounted by 5{\%}. A currency exchange rate of 1 CNY=0.1557 USD is applicable. The incremental cost-effectiveness ratio (ICER) was calculated for different screening strategies relative to nonscreening. Results: The proposed model suggested that screening led to a gain of 0.001-0.042 QALYs per person as compared with the findings in the nonscreening cohort. Meanwhile, one-time and annual screenings were associated with reductions in lung cancer--related mortality of 0.004{\%}-1.171{\%} and 6.189{\%}-15.819{\%}, respectively. The ICER ranged from 119,974.08 to 614,167.75 CNY per QALY gained relative to nonscreening. Using the World Health Organization threshold of 212,676 CNY per QALY gained, annual screening from a start age of 55 years and one-time screening from the age of 65 years can be considered as cost-effective in China. Deterministic and probabilistic sensitivity analyses were conducted. Conclusions: This economic evaluation revealed that a population-based lung cancer screening program in China for heavy smokers using low-dose computed tomography was cost-effective for annual screening of smokers aged 55-74 years and one-time screening of those aged 65-74 years. Moreover, annual lung cancer screening should be promoted in China to realize the benefits of a guideline-recommended screening program. ", issn="2369-2960", doi="10.2196/36425", url="https://publichealth.www.mybigtv.com/2022/7/e36425", url="https://doi.org/10.2196/36425", url="http://www.ncbi.nlm.nih.gov/pubmed/35793127" }