癌症早诊早治工作评价指标的探讨

目的]探讨癌症早诊早治工作的评价指标。方法]分析2006～2009年卫生部早诊早治项目宫颈癌、食管癌/贲门癌、结直肠癌、肝癌、鼻咽癌及胃癌的筛查和早诊早治数据,提出并定义癌症早诊早治工作的初步评价指标。筛查早诊率,检出率和治疗率为工作绩效指标;早期发现成本系数（early detection cost index,EDCI）为综合评价指标。结果]宫颈癌、食管癌/贲门癌、结直肠癌、肝癌、鼻咽癌及胃癌6种癌症的诊断性筛查检出率分别为：5.6%、2.4%、3.9%、1.3%、5.5%、1.5%;筛查早诊率分别为：93.5%、82.3%、91.9%、58.2%、60.0%、80.0%;治疗率分别为：90.9%、68.4%、100%、69.1%、80.0%、85.0%;早期发现成本系数分别为：0.22、0.42、0.48、0.80、2.45、1.68。结论]宫颈癌、结直肠癌及食管癌/贲门癌的早诊早治有良好的效益,应进一步推广。

The Exploration of Evaluating Indicators for Early Detection and Treatment of Cancers in China

Purpose] To investigate the evaluating indicators forearly detection and treatment of cancerprogram in China. Methods] The data came from early detection and treatment of cancers including cervix,esophagus/cardiac,colon-recta,stomach,liver and nasopharynx supported by the central government special financial transfer payment program in 2006～2009. The evaluating indicators for early detection and treatment of cancerprogram are defined. The rates of screening detection,early di-agnosis and treatment are classified as indicators of the performance. The early detection cost index （EDCI） serves as the comprehensive indicator. Results] Among the six cancers of cervix,esophagus/cardiac,colon-recta,liver,nasopharynx and stomach,the screening detection rates （on the diagnosis base）were 5.6%,2.4%,3.9%,1.3%,5.5%and 1.5%respectively. The early diagnosis rates were 93.5%,82.3%,91.9%,58.2%,60.0%and 80.0%respectively;and treatment rates were 90.9%,68.4%,100%,69.1%,80.0%and 85.0%respectively. Finally,the EDCI were 0.22,0.42,0.48,0.80,2.45 and 1.68 respectively. Conclusions] The early detection and early treatment of cervical,colorectal and esophageal/cardiac cancers demonstrate a good cost benefit. It should be generalized to broad population implementation.