هزینه اثربخشی ماموگرافی با تمرکز بر ماموگرافی سیار برای غربالگری سرطان پستان در ایران: یک مطالعه مروری

نوع مقاله : مروری

نویسندگان

1 استاد گروه علوم مدیریت و اقتصاد بهداشت، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران.

2 استاد، مرکز تحقیقات سرطان، انستیتو کانسر، دانشگاه علوم پزشکی تهران، تهران، ایران.

3 استاد گروه جراحی، دانشکده پزشکی، دانشگاه علوم پزشکی تهران، تهران، ایران.

4 دکتری تخصصی مدیریت خدمات بهداشتی و درمانی، گروه علوم مدیریت و اقتصاد بهداشت، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران.

چکیده

مقدمه: سرطان پستان، یکی از شایع­ترین سرطان­ها و از عوامل اصلی مرگ‌و‌میر در سراسر دنیا و ایران است. ماموگرافی به‌صورت رایج در غربالگری و تشخیص سرطان پستان استفاده می­شود. مطالعه حاضر با هدف ارزیابی اثربخشی و هزینه اثربخشی ماموگرافی به‌ویژه نوع سیار آن در غربالگری سرطان پستان در ایران انجام شد.
روش‌کار: در این مطالعه که از نوع مرور مطالعات مروری (overview of reviews) می­باشد، پس از جستجوی نظام­مند در پایگاه­های اطلاعاتی Cochrane Library، Trip، Pubmed، CRD و magiran گزارش­های مناسب، مرتبط و به‌روز شامل مرور نظام‌مند، ارزیابی فناوری سلامت، ارزیابی اقتصادی و راهنمای بالینی یافت شد و مورد استفاده قرار گرفت.
یافته‌ها: حساسیت ماموگرافی برای غربالگری سرطان پستان در نوع ثابت بین 84% و 96% و در نوع سیار بین 77% و 98%؛ و ویژگی آن در نوع ثابت بین 50% و 100% و در نوع سیار بین 92% و 95% گزارش شده است. در ایران استفاده از ماموگرافی در برنامه غربالگری موجب افزایش حدود 37 هزار دلار هزینه به ازای هر QALY (سال‌های زندگی با کیفیت تعدیل شده) می­شود.
نتیجه­گیری: در ایران با توجه به میزان بروز بیماری، ماموگرافی در غربالگری سرطان پستان هزینه اثربخش نیست، اگرچه در جوامع خاص مثلاً با بروز نسبتاً بالا ممکن است هزینه اثربخش باشد. ماموگرافی سیار به‌طور معمول از ماموگرافی ثابت هزینه بیشتری دارد و عملکرد فنی آن نیز تفاوت چندانی ندارد، بنابراین ممکن است هزینه اثربخشی آن از ماموگرافی ثابت هم کمتر باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Cost effectiveness of mammography focusing on mobile mammography for breast cancer screening in Iran: A review study

نویسندگان [English]

  • Ali Akbari Sari 1
  • Kazem Zendehdel 2
  • Iraj Harirchi 3
  • Farhad Habibi 4
1 Professor, Department of Health Management and Economics Sciences, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
2 Professor, Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Surgery, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
4 PhD of Health Management, Department of Health Management and Economics, School of public Health, Tehran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Breast cancer is one of the most common cancers and a leading cause of death worldwide and in Iran. Mammography is commonly used in breast cancer screening and diagnosis. This study was performed with aim to evaluate the efficacy and cost-effectiveness of mammography, especially the mobile type, in breast cancer screening in Iran.
Methods: This study is an overview of reviews. After a systematic search in the databases of Cochrane Library, Trip, Pubmed, CRD and magiran, the appropriate, relevant and up-to-date reports including systematic review, health technology assessment, economic assessment and clinical guidance were found and used.
Results: Mammography sensitivity for breast cancer screening in fixed type was reported between 84% and 96% and in mobile type between 77% and 98%. Its specificity has been reported between 50% and 100% in fixed type and between 92% and 95% in mobile type. In Iran, the use of mammography in the screening program increases the cost by about $ 37,000 per QALY (quality adjusted life years).
Conclusion: Due to the incidence of the disease, mammography is not cost effective in breast cancer screening, although in certain communities, for example, with a relatively high incidence may be cost effective. Mobile mammography is usually more expensive than fixed mammography and its technical performance is not much different, so it may be less cost effective than fixed mammography.

کلیدواژه‌ها [English]

  • Breast Cancer
  • Mammography
  • portable Mammography
  • Cost effectiveness

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مجله زنان، مامایی و نازایی ایران
دوره 24، شماره 12
بهمن 1400
صفحه 98-109

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