全民大腸直腸癌篩檢模式評估-以模擬基層醫療與社區醫院執行模式為例

Abstract

研究發現本模式架構的東區篩檢試辦方案，可以在試辦區進行，從參與比例，以較合理的科學推論，在全區145,935名接受篩檢民眾中，在理想涵蓋率下，篩檢進行一年間，將可發現677名大腸腫瘤風險患者；在這些個案當中，良性風險前期腺息肉腫瘤案例285名，後期侵襲性大腸癌案數目是44名，腫瘤前期患者是86.2%，良性腺息肉腫瘤例案較多，這些例案預後也較好，處治耗用醫療保險費用將較少。平均每一名風險前期患者將會分攤耗用1,780篩檢費用；但比較沒有提供篩檢方案地區的民眾，若發生侵襲性大腸癌症患者，每年要耗用151,976元醫療治療費用; 沒有篩檢民眾的損失，是每名患者將會冒著6.2年平均壽命損失風險，本研究摸擬篩檢分析結果，在東區執行篩檢試辦方案，可以達成早期發現，早期治療任務，本方案很有經濟價值，是一項很值得決策者投資推廣的公共政策。

The proposed population based Colorectal cancer screening project is a practical project that can be carried out in the less medical resource region of Taiwan. The ideal screening coverage rate of 50%, 677 colorectal risk cases can be identified amount 145,935 populations. The adenoma predictive rate is 86.2 %. expecting adenoma risk cases will be 285. The invasive colorectal cancer patient will be 44 cases. The screening charge for each colorectal risk case will be 1,780 NT. As comparing to the charge for the intervention for those high risk cases, the screening intervention charge is much more cost effective. This screening value predictive study introduced a cost effective option for the public health decision maker in making decision for screening strategy in the less resource region of Taiwan.