AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and th...AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.展开更多
AIM： To investigate the incidence and mortality of gastric cancer （GC） in Zhuanghe region, northeast China and the influencing factors for their changing trends.METHODS： All new cancer cases and deaths registered ...AIM： To investigate the incidence and mortality of gastric cancer （GC） in Zhuanghe region, northeast China and the influencing factors for their changing trends.METHODS： All new cancer cases and deaths registered from 2005 to 2010 in Zhuanghe County were reviewed. The annual GC cases, constituent ratio, crude rates,age-standardized rates, their sex and age distribution and temporal trends were assessed. The method of annual percentage change （APC） was used to estimate the trends of GC.RESULTS： Altogether 2634 new cases of GC and 1722 related deaths were registered, which accounted for 21.04% and 19.13% of all cancer-related incidence and deaths, respectively. The age-standardized incidence rate steadily decreased from 57.48 in 2005 to 44.53 in 2010 per 10^5 males, and from 18.13 to 14.70 per 10s females, resulting in a APC of -5.81% for males and -2.89% for females over the entire period. The magnitude of APC in GC mortality amounted to -11.09% and -15.23%, respectively, as the agestandardized mortality rate steadily decreased from 42.08 in 2005 to 23.71 in 2010 per 10^5 males, and from 23.86 to 10.78 per 10^5 females. Females had a significantly lower incidence （a male/female ratio 2.80, P 〈 0.001） and mortality （a male/female ratio 2.30, P 〈 0.001）. In both genders, the peak incidence and mortality occurred in the 80-84 years age group. The age-standardized mortality/incidence ratio also decreased from the peak of 0.73 in 2005 to 0.53 in 2010 for males, and from 1.32 to 0.73 for females.CONCLUSION： Encouraging declines of incidence and mortality of GC were observed in Zhuanghe region between 2005 and 2010, possibly due to the economic development and efficient GC control strategies.展开更多
基金Supported by The National Science and Technology Pillar Program of the 11th National Five-Year Plan of China,No. 2006BAI02A15
文摘AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.
基金Supported by Grants from the Tenth Five-Year Program for National Scientific Key Project of China,No.2004BA703B06-2973 National Basic Research Development Program of China,No.2010CB529304the funds for scientific research fromthe Financial Department of Liaoning Province,China,No.2008-621
文摘AIM： To investigate the incidence and mortality of gastric cancer （GC） in Zhuanghe region, northeast China and the influencing factors for their changing trends.METHODS： All new cancer cases and deaths registered from 2005 to 2010 in Zhuanghe County were reviewed. The annual GC cases, constituent ratio, crude rates,age-standardized rates, their sex and age distribution and temporal trends were assessed. The method of annual percentage change （APC） was used to estimate the trends of GC.RESULTS： Altogether 2634 new cases of GC and 1722 related deaths were registered, which accounted for 21.04% and 19.13% of all cancer-related incidence and deaths, respectively. The age-standardized incidence rate steadily decreased from 57.48 in 2005 to 44.53 in 2010 per 10^5 males, and from 18.13 to 14.70 per 10s females, resulting in a APC of -5.81% for males and -2.89% for females over the entire period. The magnitude of APC in GC mortality amounted to -11.09% and -15.23%, respectively, as the agestandardized mortality rate steadily decreased from 42.08 in 2005 to 23.71 in 2010 per 10^5 males, and from 23.86 to 10.78 per 10^5 females. Females had a significantly lower incidence （a male/female ratio 2.80, P 〈 0.001） and mortality （a male/female ratio 2.30, P 〈 0.001）. In both genders, the peak incidence and mortality occurred in the 80-84 years age group. The age-standardized mortality/incidence ratio also decreased from the peak of 0.73 in 2005 to 0.53 in 2010 for males, and from 1.32 to 0.73 for females.CONCLUSION： Encouraging declines of incidence and mortality of GC were observed in Zhuanghe region between 2005 and 2010, possibly due to the economic development and efficient GC control strategies.
