关键词: 胰腺肿瘤, 危险因素, 筛查, 费用效益分析

Abstract: Objective　To explore the economic benefits of risk-based screening of pancreatic cancer，providing a new way for screening of pancreatic cancer.Methods　Literature review was used to identify the risk factors of pancreatic cancer： using "pancreatic cancer" and "risk factors" or "etiology" as the search terms，we searched the electronic databases of CNKI，Wanfang Data Knowledge Service Platform and Web of Science for studies concerning the risk factors of pancreatic cancer collected from their inception to February 28，2018.We recorded and counted the number and reference rate of risk factors of pancreatic cancer extracted from the eligible studies．Models established with the data of risk-based screening of pancreatic cancer in Shanghai's Pudong New Area with CA19-9 assay were used for the economic analysis.Results　Totaled 121 studies were included，involving 19 risk factors of pancreatic cancer.As the two leading risk factors，smoking〔71.9%（87/121）〕 and diabetes〔59.5%（72/121）〕produced positive additive interaction on the incidence of pancreatic cancer〔SI=1.989，AOR（95%CI）=29.943（5.358，167.332）〕，we incorporated them in the pancreatic cancer screening conducted in Shanghai's Pudong New Area.Compared with the whole-population screening，the costs of screening of pancreatic cancer in smokers，diabetics，smokers with diabetes decreased by 90.462%，83.523%，96.377%-96.922%，respectively，while the efficiencies of these three types of screening increased by 948.4%，506.9%，2 894.3%，respectively. Conclusion　Risk-based screening of pancreatic cancer is of great significance.Screening of pancreatic cancer based on the combination of risk factors provides a new way of pancreatic cancer screening，it can narrow the target populations quickly and accurately，thereby the screening of pancreatic cancer in a region can be completed in a shorter period of time with lower costs.

Key words: Pancreatic neoplasms, Risk factors, Screening, Cost-benefit analysis