Informacja

Drogi użytkowniku, aplikacja do prawidłowego działania wymaga obsługi JavaScript. Proszę włącz obsługę JavaScript w Twojej przeglądarce.

Przeglądasz jako GOŚĆ
Tytuł pozycji:

The predicted impact and cost-effectiveness of systematic testing of people with incident colorectal cancer for Lynch syndrome.

Tytuł :
The predicted impact and cost-effectiveness of systematic testing of people with incident colorectal cancer for Lynch syndrome.
Autorzy :
Kang YJ; Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.
Killen J; Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.
Caruana M; Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.
Simms K; Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.
Taylor N; Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.
Frayling IM; Institute of Medical Genetics, University Hospital of Wales, Cardiff, United Kingdom.; Institute of Cancer and Genetics, Cardiff University, Cardiff, United Kingdom.
Snowsill T; University of Exeter Medical School, Exeter, United Kingdom.
Huxley N; Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC.
Coupe VM; Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
Hughes S; Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.
Freeman V; Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.
Boussioutas A; University of Melbourne, Melbourne, VIC.; Royal Melbourne Hospital, Melbourne, VIC.
Trainer AH; Parkville Familial Cancer Centre, Peter MacCallum Cancer Institute, Melbourne, VIC.
Ward RL; University of Sydney, Sydney, NSW.; University of New South Wales, Sydney, NSW.
Mitchell G; Parkville Familial Cancer Centre, Peter MacCallum Cancer Institute, Melbourne, VIC.
Macrae FA; Royal Melbourne Hospital, Melbourne, VIC.
Canfell K; Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.; University of Sydney, Sydney, NSW.; University of New South Wales, Sydney, NSW.
Pokaż więcej
Źródło :
The Medical journal of Australia [Med J Aust] 2020 Feb; Vol. 212 (2), pp. 72-81. Date of Electronic Publication: 2019 Oct 08.
Typ publikacji :
Journal Article; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Publication: : Pyrmont, NSW : Australasian Medical Publishing Co.
Original Publication: Sydney : Australasian Medical Pub. Co.
MeSH Terms :
Colonoscopy/*statistics & numerical data
Colorectal Neoplasms, Hereditary Nonpolyposis/*diagnosis
Cost-Benefit Analysis/*statistics & numerical data
Genetic Testing/*economics
Aged ; Australia/epidemiology ; Colonoscopy/economics ; Colorectal Neoplasms, Hereditary Nonpolyposis/economics ; Colorectal Neoplasms, Hereditary Nonpolyposis/mortality ; Female ; Humans ; Immunohistochemistry/economics ; Male ; Middle Aged
References :
Hered Cancer Clin Pract. 2019 Feb 28;17:8. (PMID: 30858900)
Asia Pac J Clin Oncol. 2018 Dec;14(6):417-425. (PMID: 30294856)
J Mol Diagn. 2012 Jul;14(4):357-66. (PMID: 22658618)
Gut. 2011 Jul;60(7):950-7. (PMID: 21193451)
Lancet Public Health. 2017 Jul;2(7):e331-e340. (PMID: 29253458)
Health Technol Assess. 2017 Sep;21(51):1-238. (PMID: 28895526)
Gastroenterology. 2000 May;118(5):829-34. (PMID: 10784581)
JAMA. 2011 Jun 8;305(22):2304-10. (PMID: 21642682)
Dis Colon Rectum. 1998 Apr;41(4):428-33. (PMID: 9559626)
J Gastroenterol Hepatol. 2018 Oct;33(10):1737-1744. (PMID: 29645364)
N Engl J Med. 2003 Mar 6;348(10):919-32. (PMID: 12621137)
J Clin Oncol. 2008 Dec 10;26(35):5783-8. (PMID: 18809606)
Health Technol Assess. 2014 Sep;18(58):1-406. (PMID: 25244061)
Appl Immunohistochem Mol Morphol. 2019 Jul;27(6):e54-e62. (PMID: 29985199)
Gastroenterology. 2018 Nov;155(5):1400-1409.e2. (PMID: 30063918)
Contributed Indexing :
Keywords: Cancer*; Colonoscopy*; Cost-benefit analysis*; Digestive system neoplasms*; Early detection of cancer*; Genetic testing*; Health policy*; Neoplasms, epidemiology*; Preventive health services*; Public health*
Entry Date(s) :
Date Created: 20191010 Date Completed: 20200331 Latest Revision: 20200331
Update Code :
20210210
PubMed Central ID :
PMC7027559
DOI :
10.5694/mja2.50356
PMID :
31595523
Czasopismo naukowe
Objectives: To evaluate the health impact and cost-effectiveness of systematic testing for Lynch syndrome (LS) in people with incident colorectal cancer (CRC) in Australia.
Design, Setting, Participants: We investigated the impact of LS testing strategies in a micro-simulation model (Policy1-Lynch), explicitly modelling the cost of testing all patients diagnosed with incident CRC during 2017, with detailed modelling of outcomes for patients identified as LS carriers (probands) and their at-risk relatives throughout their lifetimes. For people with confirmed LS, we modelled ongoing colonoscopic surveillance.
Main Outcome Measures: Cost-effectiveness of six universal tumour testing strategies (testing for DNA mismatch repair deficiencies) and of universal germline gene panel testing of patients with incident CRC; impact on cost-effectiveness of restricting testing by age at CRC diagnosis (all ages, under 50/60/70 years) and of colonoscopic surveillance interval (one, two years).
Results: The cost-effectiveness ratio of universal tumour testing strategies (annual colonoscopic surveillance, no testing age limit) compared with no testing ranged from $28 915 to $31 904/life-year saved (LYS) (indicative willingness-to-pay threshold: $30 000-$50 000/LYS). These strategies could avert 184-189 CRC deaths with an additional 30 597-31 084 colonoscopies over the lifetimes of 1000 patients with incident CRC with LS and 1420 confirmed LS carrier relatives (164-166 additional colonoscopies/death averted). The most cost-effective strategy was immunohistochemistry and BRAF V600E testing (incremental cost-effectiveness ratio [ICER], $28 915/LYS). Universal germline gene panel testing was not cost-effective compared with universal tumour testing strategies (ICER, $2.4 million/LYS). Immunohistochemistry and BRAF V600E testing was cost-effective at all age limits when paired with 2-yearly colonoscopic surveillance (ICER, $11 525-$32 153/LYS), and required 4778-15 860 additional colonoscopies to avert 46-181 CRC deaths (88-103 additional colonoscopies/death averted).
Conclusions: Universal tumour testing strategies for guiding germline genetic testing of people with incident CRC for LS in Australia are likely to be cost-effective compared with no testing. Universal germline gene panel testing would not currently be cost-effective.
(© 2019 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia Ltd on behalf of AMPCo Pty Ltd.)
Comment in: Med J Aust. 2020 Feb;212(2):69-70. (PMID: 31825091)

Ta witryna wykorzystuje pliki cookies do przechowywania informacji na Twoim komputerze. Pliki cookies stosujemy w celu świadczenia usług na najwyższym poziomie, w tym w sposób dostosowany do indywidualnych potrzeb. Korzystanie z witryny bez zmiany ustawień dotyczących cookies oznacza, że będą one zamieszczane w Twoim komputerze. W każdym momencie możesz dokonać zmiany ustawień dotyczących cookies