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[目的]拟从经济学角度对食管癌高发现场内镜筛查进行初步评价,为其大范围推广和实施提供科学依据。[方法]对2002年在食管癌高发现场河北省磁县实施的内镜筛查成本进行调查,对干预组和对照组5年全死因和恶性肿瘤发病进行监测和随访。[结果]实施内镜筛查5年后,干预组食管癌累积发病率(729.4/10万),低于对照组(482.2/10万)51.3%;干预组食管癌累积死亡率(753.9/10万)低于对照组(412.2/10万)82.93%。平均每筛查1例原位癌以上患者需要3107元,每筛查1例食管癌患者需要14206元。从筛查成本看,每少发生1例食管癌需要6255.7元,每少1例食管癌死亡需要4526.3元。[结论]在中国食管癌高发区进行内镜筛查干预是可行的,具有良好的绩效。
[Objective] To evaluate the endoscopic screening of high risk esophageal cancer field from the perspective of economics and provide a scientific basis for its wide application and implementation. [Methods] To investigate the cost of endoscopic screening in Cixian County, Hebei Province, a high incidence of esophageal cancer in 2002, and to monitor and follow up the 5-year all-cause and malignant tumor incidence in intervention group and control group. [Results] After 5 years of endoscopic screening, the cumulative incidence of esophageal cancer in the intervention group was 729.4 / 100 000, lower than 51.3% in the control group (482.2 / 100000). The cumulative esophageal cancer mortality rate in the intervention group was 753.9 / 10 Million) lower than the control group (412.2 / 100000) 82.93%. An average of 1 case of cancer screening in situ need more than 3107 yuan, screening for each case of esophageal cancer patients need 14,206 yuan. From the screening costs, every occurrence of 1 case of esophageal cancer need 6255.7 yuan, 1 case of esophageal cancer per death need 4526.3 yuan. [Conclusion] The endoscopic screening intervention in high incidence area of esophageal cancer in China is feasible and has good performance.