美国癌症筛查年度成本分析

The Annual Cost of Cancer Screening in the United States

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ANNALS OF INTERNAL MEDICINE

影响因子:15.2

分区:医学1区 Top / 医学：内科1区

发表日期:2024 Sep

作者: Michael T Halpern, Benmei Liu, Douglas R Lowy, Samir Gupta, Jennifer M Croswell, V Paul Doria-Rose

DOI: 10.7326/M24-0375

摘要

癌症具有重要的健康、生活质量和经济影响。筛查可能降低癌症死亡率和治疗成本，但美国的筛查成本尚不清楚。本文旨在估算2021年美国初次癌症筛查（不包括随访成本）的年度总费用。采用国家医疗保健调查和成本资源数据建立模型。研究对象为符合乳腺癌、宫颈癌、结直肠癌、肺癌和前列腺癌筛查条件、且具有相关数据的群体。根据保险状态，估算2021美元的筛查人数和相关医疗系统费用。2021年，美国初次癌症筛查的总医疗系统成本估算为430亿美元。其中，私人保险负担约88.3%，医疗保险（Medicare）负担8.5%，而医疗补助（Medicaid）、其他政府项目和无保险人群负担3.2%。结直肠癌筛查约占总成本的64%；结肠镜检查约占55%。检测地点的费用（即检测发生的设施费用）是总成本的主要驱动因素。所有关于癌症筛查的资料均基于国家医疗调查的自报数据，不包括阳性或异常筛查结果的随访成本。地理位置和医疗提供者或机构的差异未被完全反映。2021年，美国初次癌症筛查的年度总成本估算为430亿美元，低于诊断后前12个月的癌症治疗年度总费用。识别筛查成本及其驱动因素对政策制定和项目优先级的制定具有重要意义，特别是为了改善推荐的癌症筛查服务的可及性。

Abstract

Cancer has substantial health, quality-of-life, and economic impacts. Screening may decrease cancer mortality and treatment costs, but the cost of screening in the United States is unknown.To estimate the annual cost of initial cancer screening (that is, screening without follow-up costs) in the United States in 2021.Model using national health care survey and cost resources data.U.S. health care systems and institutions.People eligible for breast, cervical, colorectal, lung, and prostate cancer screening with available data.The number of people screened and associated health care system costs by insurance status in 2021 dollars.Total health care system costs for initial cancer screenings in the United States in 2021 were estimated at $43 billion. Approximately 88.3% of costs were attributable to private insurance; 8.5% to Medicare; and 3.2% to Medicaid, other government programs, and uninsured persons. Screening for colorectal cancer represented approximately 64% of the total cost; screening colonoscopy represented about 55% of the total. Facility costs (amounts paid to facilities where testing occurred) were major drivers of the total estimated costs of screening.All data on receipt of cancer screening are based on self-report from national health care surveys. Estimates do not include costs of follow-up for positive or abnormal screening results. Variations in costs based on geography and provider or health care organization are not fully captured.The $43 billion estimated annual cost for initial cancer screening in the United States in 2021 is less than the reported annual cost of cancer treatment in the United States in the first 12 months after diagnosis. Identification of cancer screening costs and their drivers is critical to help inform policy and develop programmatic priorities, particularly for enhancing access to recommended cancer screening services.None.