Impact of colorectal cancer screening programme on survival and employment in Taiwan: A nationwide analysis of real-world data.

IF 5.8 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY United European Gastroenterology Journal Pub Date : 2024-10-15 DOI:10.1002/ueg2.12685

Wei-Ying Chen, Yi-Peng Lu, Yu-Wen Chien, Li-Jung Elizabeth Ku, Jung-Der Wang

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Abstract

Background: Colorectal cancer (CRC) leads to life loss and a significant economic burden, which could be reduced by CRC screening.

Objective: We assessed the potential savings of lives and employment to evaluate the effectiveness of the Taiwan CRC Screening Programme.

Methods: 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.

Results: 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.

Conclusion: 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.

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台湾大肠癌筛查计划对生存和就业的影响：对真实世界数据的全国性分析。

背景：大肠癌（CRC）导致生命损失和巨大的经济负担：大肠癌（CRC）会导致生命损失和巨大的经济负担，而大肠癌筛查可以减少这些损失和负担：我们评估了可能节省的生命和就业，以评价台湾 CRC 筛查计划的有效性：通过台湾癌症登记处、国民死亡率登记处、台湾 CRC 筛查数据库和国民健康保险理赔数据之间的相互关联，我们登记了年龄在 50-74 岁之间、在 2004-2017 年期间确诊的结直肠腺癌患者，并对他们进行随访至 2018 年。我们计算了预期寿命（LE）、终生就业时间（LED）、LE损失和LED损失，并与年龄、性别和日历年匹配的队列进行了比较。假定筛查出与未筛查出的 CRC 在特定阶段内没有差异，并根据不同阶段的分布对它们进行加权，我们比较了总 Loss-of-LE 和 Loss-of-LED 的情况：该队列共纳入 77,169 名结直肠腺癌患者，其中包括 31,728 名女性（平均 [SD] 年龄为 62.5 [7.1] 岁）和 45,441 名男性（平均 [SD] 年龄为 62.8 [6.8] 岁）。女性的 LLE 和 LED 平均损失年数分别为 6.0 年（95% 置信区间 [CI] 5.7-6.3 年）和 1.0 年（95% 置信区间 0.8-1.1 年），而男性则分别为 5.1 年（95% 置信区间 4.9-5.4 年）和 1.1 年（95% 置信区间 1.0-1.2 年）。队列中有 53,678 个病例获得了筛查信息。平均而言，每名女性病例可通过筛查节省 2.9 (95% CI 2.6-3.2) 年的预期寿命和 0.5 (95% CI 0.4-0.6) 年的就业年限，男性病例可通过筛查节省 2.7 (95% CI 2.5-3.0) 年的预期寿命和 0.6 (95% CI 0.5-0.7) 年的就业年限：结论：台湾的 CRC 筛查计划与挽救生命和延长就业时间有关。结论：台湾的 CRC 筛查计划与节省生命和就业时间有关。未来的研究有必要在考虑节省的就业损失和可能调整的准备时间偏差后，评估在较年轻时开始筛查的成本效益。

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来源期刊

United European Gastroenterology Journal GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

10.50

自引率

13.30%

发文量

147

期刊介绍： United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.