成本效益分析探討子宮頸癌、口腔癌篩檢策略：文獻系統回顧

Cost- Effectiveness Analysis on Screening Strategies for Cervical Cancer and Oral Cavity Cancer: A Systematic Review

江向才(Hsiang-Tsai Chiang) ； 杜俊毅(Chun-Yi Tu)

《台灣健康照顧研究學刊》 20期 (2019/07) Pp. 1-35

摘要

台灣無口腔癌篩檢成本效益研究，子宮頸抹片檢查降低死亡率及篩檢率呈現停滯，人類乳突病毒（HPV）疫苗接種預防及治療子宮頸癌、口腔癌的防治策略已成國際趨勢。本研究以文獻系統回顧分析全球二十國家學者子宮頸癌篩檢22篇、口腔癌篩檢6篇，結果發現子宮頸癌篩檢具成本效益共20篇；口腔癌篩檢具成本效果共6篇，表明子宮頸抹片檢查仍是全球子宮頸癌最具成本效益篩檢策略、HPV細胞學檢測具成本效益是醫療資源貧乏國家替代方案，子宮頸癌HPV疫苗接種具成本效益是未來防治方向；口腔癌黏膜篩檢雖有爭議但研究結果具成本效益，表明有計劃執行年度子宮頸癌及口腔癌篩檢策略具成本效益，我們支持台灣子宮頸癌及口腔癌篩檢國家防治策略值得持續推廣。現今如何減輕民眾對篩檢的畏懼及增加意願來提高篩檢率，HPV細胞學檢測可考慮放寬篩檢對象及HPV疫苗接種防治擴大推廣年輕女孩及男孩HPV疫苗防治子宮頸癌及口腔癌計劃可提供未來政策參考。

關鍵字

子宮頸癌 ； 口腔癌 ； 篩檢策略 ； 成本效益分析 ； 文獻系統回顧

並列摘要

There is no cost-effectiveness study for oral cavity cancer screening in Taiwan. The cervical smear screening to reduce mortality and screening rate shows stagnation. The vaccination prevention of the Human Papilloma Virus (HPV) and the prevention strategy of cervical cancer, oral cancer has become an international trend. This study uses literature review to analyze 22 cervical cancer screenings and 6 oral cancer screenings in 20 countries. The results showed that cervical cancer screening has cost-effective of 20 articles, and oral cancer screening was 6 articles. Shows that cervical smear screening is still the most cost-effective screening strategy for cervical cancer worldwide. The cost-effectiveness of HPV cytology testing is an alternative to poorly resourced medical countries and the cost-effectiveness of cervical cancer HPV vaccination is the future direction of prevention. Oral cancer mucosal screening is controversial but the results are cost-effective. Shows that there are plans to implement annual cervical cancer and oral cancer screening strategies that are cost-effective. We support that Taiwan's cervical cancer and oral cancer screening national control strategy is worth promoting. Today's issues on how to reduce public fear of screening and increase willingness to increase screening rates. HPV cytology testing may consider relaxing screening targets and expanding the promotion of HPV vaccine for young girls and boys to prevent cervical cancer and oral cancer programs can provide future policy reference.

並列關鍵字

Cervical Cancer ； Oral Cavity Cancer ； Screening Strategies ； Cost- effectiveness Analysis ； A Systematic Review

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