職員胃検診における各種健診法の費用と効果についての検討

We performed this study to assess the cost and efficacy of several kinds of mass screening methods for gastric cancer. The data of pepsinogen methods previously performed in Izumo-shi and endoscopic method performed by Uemura and his coworkers were used in this study. The cost to detect one patient with gastric cancer in the members of our faculty by the combination method of measurement of serum anti-Helicobacter pylori antibody and pepsinogen level was estimated at 2.04 million yen, and that by pepsinogen mehod was estimated at 1.56 million yen. On the other hand, the costs to detect one patient with gastric cancer by the method of annual endoscopic examination for all members and the members with Helicobacter pylori infection were estimated at 0.48 and 0.304 million yen, respectively. In conclusion, the method of annual endoscopic examination for the members with Helicobacter pylori infection seems to be effective for the members of our faculty.

島根大学医学部職員に各種の胃検診を行った場合の費用と予想胃癌発見数を明らかにすることを目的として検討を行った。解析には平成20年度胃検診対象者，出雲市およびJA 島根厚生連のペプシノーゲン法（ぺ法）の費用および成績，Uemura らの報告による内視鏡による癌発見率のデータを用いた。なお，H. pylori（HP）抗体，ぺ法は５年間に１度の測定とした。HP 抗体＋ぺ法およびペ法単独ではそれぞれ５年間で204万円，156万円の費用で１人の癌発見と推測された。全員に毎年上部内視鏡を行うと48万円の費用で１人の癌発見と推測された。HP 抗体を測定し陽性者のみに毎年内視鏡を行うと30万円の費用で１人の癌発見と推測された。最も費用対効果に優れていると考えられたのはHP 抗体測定＋内視鏡と考えられた。