结直肠癌筛查计划对台湾生存和就业的影响：全国性数据分析
Impact of colorectal cancer screening programme on survival and employment in Taiwan: A nationwide analysis of real-world data
影响因子:6.70000
分区:医学2区 / 胃肠肝病学3区
发表日期:2024 Dec
作者:
Wei-Ying Chen, Yi-Peng Lu, Yu-Wen Chien, Li-Jung Elizabeth Ku, Jung-Der Wang
摘要
结直肠癌（CRC）会导致生命损失和重大的经济负担，可以通过CRC筛查来减少。我们评估了台湾CRC筛查程序的有效性，以评估台湾CRC筛查程序的有效性。腺癌，年龄为50-74岁，在2004年至2017年期间被诊断出，直到2018年。预期寿命（LE），终生就业持续时间（LED），LE和LED丧失和LED损失，与年龄，性别和日历年龄在年中相比。假设在特定阶段没有检测到的CRC的特定阶段与未检测到的CRC并通过不同的阶段分布进行权重，我们比较了总LE损失和LED的总损失和下降的损失。招募77,169例结直肠腺癌的患者，其中包括结直肠腺癌的患者，其中包括31,728名女性（平均[SD]男性，年龄在62.5 [7.1]和4.1岁）和4.1岁（SD），45.142. 45,42. 45.14.15,4.45,4.45,4.45,42.45,42。 [6.8]年）。女性的平均LE损失和LED为6.0（95％置信区间[CI] 5.7-6.3）和1.0（95％CI 0.8-1.1）年（S），而男性的平均置信区为5.1（95％CI 4.9-5.4）和1.1（95％CI 4.9-5.4）和1.1（95％CI 1.0-1.2）。在队列中，有53,678例具有筛查信息。平均而言，筛查可能会节省2.9（95％CI 2.6-3.2）年的预期寿命，加上0.5（95％CI 0.4-0.6）妇女的就业年份，2.7年（95％CI 2.5-3.0），加上0.6（95％CI 0.5-0.7）年的男性均与寿命相关联。有必要进行未来的研究，以评估在减轻就业损失并可能调整交货时间偏见后，在年轻时开始筛查的成本效益。
Abstract
Colorectal cancer (CRC) leads to life loss and a significant economic burden, which could be reduced by CRC screening.We assessed the potential savings of lives and employment to evaluate the effectiveness of the Taiwan CRC Screening Programme.Through interlinkages among Taiwan Cancer Registry, National Mortality Registry, Taiwan CRC Screening Database, and National Health Insurance claim data, we enroled patients with colorectal adenocarcinoma, aged 50-74 years and diagnosed during 2004-2017, and followed them up to 2018. Life expectancy (LE), lifetime employment duration (LED), loss-of-LE and loss-of-LED were calculated, compared with age-, sex- and calendar year-matched cohorts. Assuming no difference within a specific stage for screen-detected versus non-screen detected CRC and weighting them by different stage distributions, we compared the total loss-of-LE and loss-of-LED.The cohort enroled 77,169 patients with colorectal adenocarcinoma, which included 31,728 women (mean [SD] age, 62.5 [7.1] years) and 45,441 men (mean [SD] age, 62.8 [6.8] years). The mean loss-of-LE and loss-of-LED in women were 6.0 (95% confidence interval [CI] 5.7-6.3) and 1.0 (95% CI 0.8-1.1) year(s), whereas those in men were 5.1 (95% CI 4.9-5.4) and 1.1 (95% CI 1.0-1.2) years, respectively. Among the cohort, 53,678 cases had the screening information. On average, screening potentially saved 2.9 (95% CI 2.6-3.2) years of life expectancy plus 0.5 (95% CI 0.4-0.6) years of employment per case in women and 2.7 (95% CI 2.5-3.0) years plus 0.6 (95% CI 0.5-0.7) years in men, respectively.The Taiwan CRC Screening Programme is associated with the savings of lives and employment duration. Future studies are warranted to evaluate the cost-effectiveness of beginning screening at a younger age after accounting for saving employment loss and possibly adjusting lead time bias.