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目的探讨3种宫颈癌筛查方案的筛查效能及成本效果。方法对广州市1 148例妇女采用宫颈液基薄层细胞学(LCT)和高危型人乳头瘤病毒(HR-HPV)联合检测法进行宫颈癌筛查,按LCT,HPV,以及LCT与HPV联合检测3种方案分析各筛查策略的效果,并利用成本效果分析,比较各筛查策略的经济学特性。结果筛查方案中LCT阳性检出率为6.97%,漏诊率为20.00%,阳性预测值为40.00%;HPV筛查阳性检出率为13.41%,漏诊率为5.00%,阳性预测值为24.70%;联合筛查阳性检出率17.68%,漏诊率为0%,阳性预测值为24.50%。3种筛查方案的效果:联合筛查>HPV筛查>细胞学筛查。成本效果分析显示,HPV筛查的成本效果比值最低,具有一定的经济性。结论 3种方案中联合筛查的筛查效能最高,HPV筛查最具有经济性。
Objective To investigate the screening efficacy and cost effect of three kinds of cervical cancer screening programs. Methods A total of 1 148 women in Guangzhou were screened for cervical cancer by LCT and HR-HPV combined with LCT, HPV and LCT combined with HPV Three programs were tested to analyze the effectiveness of each screening strategy, and the cost-effectiveness analysis was used to compare the economic characteristics of each screening strategy. Results The positive detection rate of LCT was 6.97%, the rate of misdiagnosis was 20.00% and the positive predictive value was 40.00%. The positive rate of HPV screening was 13.41%, the rate of misdiagnosis was 5.00% and the positive predictive value was 24.70% ; The combined detection positive rate was 17.68%, the rate of missed diagnosis was 0%, the positive predictive value was 24.50%. Effect of 3 screening protocols: Combined Screening> HPV Screening> Cytology Screening. Cost-effectiveness analysis shows that HPV screening has the lowest cost-effectiveness ratio and economy. Conclusion The combined screening of the three kinds of programs has the highest screening efficiency and HPV screening is the most economical.