文章：

欧洲国家乳腺癌筛查模式成本效益的系统性综述

A Systematic Review of the Cost-Effectiveness of Screening Modalities for Breast Cancer in European Countries

原文发布日期：6 November 2025

DOI: 10.3390/cancers17213585

类型: Article

开放获取: 是

英文摘要：

Background: Breast cancer remains the most diagnosed cancer in European countries, with diverse screening modalities requiring economic evaluation for optimal resource allocation. This systematic review evaluated the cost-effectiveness of breast cancer screening strategies across European healthcare contexts. Methods: We conducted a comprehensive search across PubMed, ScienceDirect, Cochrane Library, Scopus, and Google Scholar following PRISMA guidelines (1990–2024). Studies were evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Economic standardization employed healthcare-specific inflation indices and purchasing power parity adjustments, with costs converted to 2020 EUR. Results: From 1449 studies, 23 met inclusion criteria, with significant geographic imbalance (74% from North-Western/Central Europe, 4% from South-Eastern Europe). Mammography screening for women aged 50–69 years demonstrated consistent cost-effectiveness (EUR 3000–8000 per quality-adjusted life year (QALY)) with high confidence. For women under 50, screening showed substantially higher costs (EUR 105,000 per year of life saved). Magnetic resonance imaging (MRI) screening showed cost-effectiveness for high-risk populations (EUR 18,201–33,534 per QALY) with moderate confidence. Conclusions: Biennial mammography screening for women aged 50–69 demonstrates consistent cost-effectiveness across European contexts. Findings have highest applicability to North-Western and Central European healthcare systems, with limited generalizability to Southern and Eastern Europe due to evidence gaps.

摘要翻译： 

背景：在欧洲国家，乳腺癌仍是确诊率最高的癌症，其多样化的筛查方式需要进行经济评估以实现资源优化配置。本系统综述评估了欧洲不同医疗体系下乳腺癌筛查策略的成本效益。 方法：我们遵循PRISMA指南（1990–2024年），在PubMed、ScienceDirect、Cochrane Library、Scopus和Google Scholar数据库进行了全面检索。研究采用《卫生经济学评价报告标准》（CHEERS）清单进行评估。经济数据标准化处理采用医疗行业特定通胀指数和购买力平价调整，所有成本均转换为2020年欧元值。 结果：在1449项研究中，23项符合纳入标准，但存在显著地域不平衡（74%来自西北欧/中欧，仅4%来自东南欧）。针对50–69岁女性的乳腺X线筛查显示出稳定成本效益（每质量调整生命年成本3000–8000欧元），置信度较高。对于50岁以下女性，筛查成本显著更高（每挽救生命年成本达105,000欧元）。针对高风险人群的磁共振成像筛查具有成本效益（每质量调整生命年成本18,201–33,534欧元），置信度中等。 结论：针对50–69岁女性的两年期乳腺X线筛查在欧洲范围内展现出稳定的成本效益。研究结果对西北欧和中欧医疗体系最具适用性，由于证据缺口，对南欧和东欧地区的普适性有限。

原文链接：

A Systematic Review of the Cost-Effectiveness of Screening Modalities for Breast Cancer in European Countries