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目的 对全球范围内应用Markov模型进行肺癌筛查卫生经济学评价的研究进行总结与分析。方法 系统检索国内外发表的应用Markov模型进行肺癌筛查卫生经济学评价研究的相关文献。结果 共有13篇符合纳入标准的研究，其中4项研究来自中国，其余9项均来自国外。筛查技术均为低剂量螺旋CT,筛查频率以1年1次为主，采用Markov模型模拟结果，有11项研究表明低剂量螺旋CT筛查肺癌具有成本效益，2项研究结果显示不具有成本效益。部分研究考虑了不同筛查起始年龄对经济效益的影响，尚没有明确最佳筛查起始年龄。结论 现有的经济学评价证据表明，在结合年龄和吸烟史选择的高危人群中开展每年1次的低剂量螺旋CT肺癌筛查有很高的概率经济有效，这为肺癌筛查证据有限的地区提供了参考。但由于不同国家发展水平不同，卫生系统的筛查、诊断以及癌症治疗的成本也不同，低剂量螺旋CT筛查肺癌在我国具有成本效益的证据尚不充分，应结合我国的肺癌筛查实践和本土化数据开展中国研究，拟定适合中国国情的筛查方案。
Abstract：[1] FREDDIE B,JACQUES F,ISABELLE S,et al.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J].CA Cancer J Clin,2018,68(6):394-424.
[2] DETTERBECK F C,BOFFA D J,KIM A W,et al.The eighth edition lung cancer stage classification [J].J Circ Respir Relat Syst,2017,151(1):193-203.
[3] DR A,AM A,CD B,et al.Reduced lung-cancer mortality with low-dose computed tomographic screening [J].N Engl J Med,2011,365(5):395-409.
[4] KAY R.A Markov model for analysing cancer markers and disease states in survival studies [J].Biometrics,1986,42(4):855-65.
[5] 王頔，马磊，陈宇，等.基于马尔科夫链的医疗决策 [J].现代生物医学进展，2017,17(11):2185-2189.
[6] LUO S.Joint analysis of stochastic processes with application to smoking patterns and insomnia [J].Stat Med,2013,32(29):5133-5144.
[7] ESCANDELL-MONTERO P,CHERMISI M,MARTINEZ-MARTINEZ J M,et al.Optimization of anemia treatment in hemodialysis patients via reinforcement learning [J].Artif Intell Med,2014,62(1):47-60.
[8] 王剑，赵加奎，魏晓敏，等.经济学评价方法现状及在公共卫生领域的应用 [J].中国卫生资源，2013 (5):353-355.
[9] 刘成成，石菊芳，刘国祥，等.全球肺癌筛查卫生经济学研究的系统评价 [J].中华流行病学杂志，2019,40(2):218-226.
[10] MAHADEVIA P J,FLEISHER L A,FRICK K D,et al.Lung cancer screening with helical computed tomography in older adult smokers:a decision and cost-effectiveness analysis [J].JAMA,2003,289(3):313-322.
[11] MANSER R,DALTON A,CARTER R,et al.Cost-effectiveness analysis of screening for lung cancer with low dose spiral CT (computed tomography) in the Australian setting [J].Lung Cancer,2005,48(2):171-185.
[12] CRESSMAN S,PEACOCK S J,TAMMEM?GI M C,et al.The cost-effectiveness of high-risk lung cancer screening and drivers of program efficiency [J].J Thorac Oncol,2017,12(8):1210-1212.
[13] HOFER F,KAUCZOR H U,STARGARDT T.Cost-utility analysis of a potential lung cancer screening program for a high-risk population in Germany:a modelling approach [J].Lung Cancer,2018,124:189-198.
[14] JAINE R,KVIZHINADZE G,NAIR N,et al.Cost-effectiveness of a low-dose computed tomography screening programme for lung cancer in New Zealand [J].Lung Cancer,2018,124:233-240.
[15] 马婧，乔良，李强，等.基于Markov模型的肺癌筛查卫生经济学评价研究 [J].中国慢性病预防与控制，2020,28(11):801-804.
[16] 王静西.河北省肺癌筛查情况及卫生经济学分析 [D].石家庄：河北医科大学，2020.
[17] ESMAEILI M H,SEYEDNEJAD F,MAHBOUB-AHARI A,et al.Cost-effectiveness analysis of lung cancer screening with low-dose computed tomography in an Iranian high-risk population [J].J Med Screen,2021,28(4):494-501.
[18] GóMEZ-CARBALLO N,FERNáNDEZ-SOBERóN S,REJAS-GUTIéRREZ J.Cost-effectiveness analysis of a lung cancer screening programme in Spain [J].Eur J Cancer Prev,2021.
[19] KIM J,CHO B,KIM S H,et al.Cost utility analysis of a pilot study for the Korean lung cancer screening project [J].Cancer Res Treat,2021.
[20] SUN C,ZHANG X,GUO S,et al.Determining cost-effectiveness of lung cancer screening in urban Chinese populations using a state-transition Markov model [J].BMJ Open,2021,11(7):e046742.
[21] KHAYAT M,EIJSINK J F H,POSTMA M J,et al.Cost-effectiveness of screening smokers and ex-smokers for lung cancer in the Netherlands in different age groups [J].Eur J Health Econ,2022:18.
[22] YUAN J,SUN Y,WANG K,et al.Cost effectiveness of lung cancer screening with low-dose CT in heavy smokers in China [J].Cancer Prev Res,2022,15(1):37-44.
[23] VAN BAAL P,MORTON A,BROUWER W,et al.Should cost effectiveness analyses for NICE always consider future unrelated medical costs [J].BMJ,2017,359:j5096.
[24] CRISS S D,CAO P,BASTANI M,et al.Cost-effectiveness analysis of lung cancer screening in the United States:a comparative modeling study [J].Ann Inter Med,2019,171(11):796-804.
[25] TEN HAAF K,VAN ROSMALEN J,DE KONING H J.Lung cancer detectability by test,histology,stage,and gender:estimates from the NLST and the PLCO trials [J].Cancer Epidemiol Biomarkers Prev,2015,24(1):154-161.
[26] ZHOU Q,FAN Y,WU N,et al.Demonstration program of population-based lung cancer screening in China:rationale and study design [J].Thorac Cancer,2014,5(3):197-203.
[27] 代敏，石菊芳，李霓.中国城市癌症早诊早治项目设计及预期目标 [J].中华预防医学杂志，2013,47(2):179-182.
基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2023.06.022
中图分类号:R734.2;R1
引用信息:
[1]刘乃嘉,张晨光,苏强,等.基于Markov模型的肺癌筛查卫生经济学评价[J].卫生研究,2023,52(06):1000-1006.DOI:10.19813/j.cnki.weishengyanjiu.2023.06.022.
基金信息:
北京市科委-教委科技发展计划重点项目(No.KZ202010025047); 国家自然科学基金重大研究计划培育项目(No.92046015);国家自然科学基金面上项目(No.72274127)
2023-11-14
2023-11-14