Journal of the Korean Data and Information Science Society

The Korean Data and Information Science Society (한국데이터정보과학회)
권호 표지

Cervical cancer screening strategies based on stochastic process

확률모형을 이용한 자궁경부암 조기검진 전략

  • 피영규 (대구한의대학교 보건학부) ;
  • 이정희 (대구한의대학교 보건학부) ;
  • 정성화 (대구한의대학교 보건학부)
  • Published : 2010.01.31
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Abstract

The purpose of this study was to investigate the most cost-effectiveness screening strategies for cervical cancer in Korea. We calculated the age-specific cervical cancer incidence rate from Korea Central Cancer Registry (2003), and then estimated the schedule sensitivity, detection probability, and screening and confirmative costs of each screening strategy based on the stochastic process (Lee and Zelen, 1998). The efficiency of the screening strategy was evaluated by incremental cost-effectiveness analysis. The most effective strategy was every 3 years pap smear test between the age of 35 and 65 years in the cervical cancer screening. The findings of this study will be helpful to evaluate efficiency of cancer screening strategies, and to provide the theoretical background of development and assessment of early detection of cancer in Korea.

본 논문에서는 우리나라 자궁경부암 조기검진 권고안을 바탕으로 검진주기 및 검진연령 변화에 따른 다양한 검진전략들의 효율성을 검토하고 비용-효과분석을 통하여 비용-효과적인 대안을 찾아 제시하고자 하였다. 한국중앙암등록본부의 2002년 자료와 확률모형을 이용하여 고려된 검진전략을 검진의 민감도와 무증상 상태에 있는 암 환자를 발견할 확률 및 검진비용을 추정하여 비용-효과분석을 시행하였다. 연구결과 비용-효과적인 측면에서 자궁경부세포검사를 이용한 35세부터 65세까지 3년 주기의 검진전략이 상대적으로 높은 효율성을 나타내었다.

Keywords

References

  1. 곽민선, 성나영, 양정희, 박은철, 최귀선 (2006). 여성의 암 검진에 대한 지불의사. <예방의학회지>, 39, 205- 212.
  2. 박상민, 장윤정, 윤영호, 유태우, 허봉렬, 권순만 (2004). 대장암 선별검사의 비용-효과분석. <가정의학회지>, 25, 297-306.
  3. 통계청 (2007). <2006년 사망원인통계>, 통계청, 대전.
  4. 한국중앙암등록본부 (2003). <한국중앙암등록사업 연례 보고서 (2002.1-2002.12)>, 한국중암암등록본부, 서울.
  5. 한국중앙암등록본부 (2005). <암 발생 통계 (1999-2002)>, 중앙암등록본부, 서울.
  6. Cokkinides, V., Bandi, P., Siegel, R., Ward, E. M. and Thun, M. J. (2007). Cancer prevention & early detection facts & figures 2008, American Cancer Society, Atlanta.
  7. DeVita, V. T., Rosenberg, S. A. and Hellman, S. (1997). Cancer: principles & practice of oncology, 5th Ed., Lippincott Williams & Willkins Publishers, Philadelphia.
  8. Drummond, M. F. (1997). Methods for the economic evaluation of health care programs, Oxford University Press, New York.
  9. Eddy, D. M. (1990). Screening for cervical cancer. Annals of Internal Medicine, 113, 214-226. https://doi.org/10.7326/0003-4819-113-3-214
  10. Ferlay, J., Bray, F., Pisani, P. and Parkin, D. M. (2004). Globocan 2002: cancer incidence, mortality and prevalence worldwide. IARC Press, Lyon.
  11. Kim, Y. K., Sung, J. H. and Kang J. C. (2007). Exploring the appropriate operation ratio on hospital revenue cost and profit. Journal of Korean Data & Information Science Society, 18, 31-40.
  12. Lee, S. J. and Zelen, M. (1998). Scheduling periodic examinations for early detection of disease: Application to breast cancer. Journal of the American Statistical Association, 93, 1271-1281. https://doi.org/10.2307/2670042
  13. Lee, S. Y., Jeong, S. H., Kim, Y. N., Kim, J., Kang, D. R., Kim, H. C. and Nam, C. M. (2009). Costeffective mammography screening in Korea: High incidence of breast cancer in young women. Cancer Science, 100, 1105-1111. https://doi.org/10.1111/j.1349-7006.2009.01147.x
  14. National Health Insurance Cooperation (2007). Contracting medical price in national health insurance cooperation, National Health Insurance Cooperation, Seoul.
  15. Park, S. G. and Choi, J. Y. (2005). An improved estimator of PPV from the screening test. Journal of Korean Data & Information Science Society, 16, 419-428.
  16. Phillips, M., Feachem, R. G. A. and Kolpan, J. P. (1992). The emerging agenda for adult health. In The health of adults in the developing world, Eds. Murray, C. J. L., Feachem, R. G. A., Kjellstrom, T., Over, M. and Phillips, M., Oxford University Press, Oxford.
  17. Ransohoff, D. F. and Sandler, R. S. (2002). Screening for colorectal cancer. New England Journal of Medicine, 346, 40-44. https://doi.org/10.1056/NEJMcp010886
  18. Schiffman, M., Castle, P. E., Jeronimo, J., Rodriguez, A. C. and Wacholder, S. (2007). Human papillomavirus and cervical cancer. Lancet, 370, 890-907. https://doi.org/10.1016/S0140-6736(07)61416-0
  19. Song, J. J., Yu, P., Ren, Y. and Chung, M. H. (2009). Correspondence analysis for studying association between geography and cancer. Journal of Korean Data & Information Science Society, 20, 919-924.
  20. Tomita, M., Otake, M. and Moon, S. H. (2006). Statistical assessment on cancer risks of ionizing radiation and smoking based on Poisson models. Journal of Korean Data & Information Science Society, 17, 581-598.
  21. Woo, P. P., Kim, J. J. and Leung, G. M. (2007). What is the most cost-effective population-based cancer screening program for Chinese women?. Journal of Clinical Oncology, 25, 617-624. https://doi.org/10.1200/JCO.2006.06.0210
  22. World Health Organization (2003). National cancer control programmes: Polices and managerial guidelines, WHO, Geneva.
  23. Zelen, M. and Feinleib, M. (1969). On the theory of screening for chronic disease. Biometrika , 56, 601-614. https://doi.org/10.1093/biomet/56.3.601