ABSTRACT

Background:Presently, there are no national screening programs for cancer in Vietnam. This study aimed to analyze the cost-effectiveness of an annual colorectal cancer (CRC) screening program from the healthcare service provider’s perspective for the Vietnamese population.

Methods:The economic model consisted of adecision tree and aMarkov model. Adecision tree was constructed for comparing two strategies, including ascreening group with aguaiac-based fecal occult blood test (gFOBT) and ano-screening group in general populations, aged 50 years and above. The Markov model projected outcomes over a25-year horizon. The cost-effectiveness outcome was the incremental cost-effectiveness ratio (ICER) represented by costs per quality-adjusted life-years (QALYs).

Results:When compared with no screening, ICER was $1,388per QALY with an increased cost of $ 43.98 and again of 0.032 QALY (Willingness to pay $2,590). The uptake rate of gFOBT, cost of colonoscopy, and the total cost of screening contributed to the largest impact on the ICER. PSA showed that results were robust to variation in parameter estimates, with annual screening remaining cost-effective compared with no screening.

Conclusion:Our screening strategy could be considered cost-effective compared to ano screening strategy. Our findings could be potentially used to develop aCRC national screening program.

 抽象的

背景：目前，越南没有国家癌症筛查计划。本研究旨在从医疗服务提供者的角度分析越南人口年度结直肠癌 (CRC) 筛查计划的成本效益。

方法：经济模型由决策树和马尔可夫模型组成。构建决策树来比较两种策略，包括使用基于水的粪便潜血试验（ g FOBT）的筛查组和50岁及以上一般人群的无筛查组。马尔可夫模型预测了 25 年范围内的结果。成本效益结果是增量成本效益比（ICER），以每质量调整生命年（QALY）的成本表示。

结果：与未筛查相比，ICER 为每 QALY 1,388 美元，成本增加了 43.98 美元，并且再次增加了 0.032 QALY（愿意支付 2,590 美元）。 gFOBT 的采用率、结肠镜检查费用和筛查总费用对 ICER 的影响最大。 PSA 表明，结果对于参数估计值的变化是稳健的，与不进行筛查相比，每年进行筛查仍然具有成本效益。

结论：与无筛选策略相比，我们的筛选策略可以被认为是具有成本效益的。我们的研究结果有可能用于制定 CRC 国家筛查计划。