The Cost-Effectiveness of Salpingectomies for Family Planning in the Prevention of Ovarian Cancer
| Autor: | R.W. Melissa Tai, Stephanie K. Y. Choi, Peter C. Coyte |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Cost effectiveness Sterilization Tubal Cost-Benefit Analysis Gynecologic oncology Bilateral Salpingectomy 03 medical and health sciences Salpingectomy 0302 clinical medicine Pregnancy medicine Humans CLIPS computer.programming_language Ovarian Neoplasms 030219 obstetrics & reproductive medicine Cancer prevention business.industry General surgery Obstetrics and Gynecology Cost-effectiveness analysis Prophylactic Surgical Procedures medicine.disease female genital diseases and pregnancy complications Surgery Pregnancy Ectopic Models Economic 030220 oncology & carcinogenesis Family Planning Services Female Ovarian cancer business computer Incremental cost-effectiveness ratio |
| Zdroj: | Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC. 40(3) |
| ISSN: | 1701-2163 |
| Popis: | Objective Ovarian cancer is the most lethal gynaecologic cancer. Disease prevention may be the only method to reduce the incidence of ovarian cancer. The Society of Gynecologic Oncology advised that salpingectomies may be an appropriate and feasible strategy for ovarian cancer risk reduction. This study conducted an economic evaluation from a societal perspective of bilateral salpingectomies versus conventional sterilization techniques in the prevention of ovarian cancer. Study Design We performed a micro-cost analysis comparing laparoscopic tubal coagulation, tubal clips and bilateral salpingectomies at the Michael Garron Hospital, formerly the Toronto East General Hospital, from 2015 to 2016. A Markov model was used in the cost-effectiveness and cost-utility analyses on these surgical procedures in ovarian cancer prevention. Costs were derived for the number ovarian cancer cases observed per sterilization method, cancer treatment, and associated procedural costs over each cancer patient's lifetime. The number of bilateral salpingectomies required to prevent an additional ovarian cancer case with the recommended treatment was also estimated. Results Bilateral salpingectomies performed at the Michael Garron Hospital generated savings of $7823 per life-year gained (95% CI $3248–$10 190; incremental cost [ΔC] −$907, incremental effect [ΔE] 0.11 life-years gained) compared with tubal clips and savings of $6315 per life-year gained (95% CI −$6360 to $9342; ΔC −$755, ΔE 0.11 life-years gained) compared with tubal coagulation. Most importantly, for every 150 bilateral salpingectomies performed, one case of ovarian cancer may be prevented. Conclusion Laparoscopic bilateral salpingectomy is the dominant, cost-effective surgical strategy when compared to tubal clips and tubal coagulation to prevent ovarian cancer. Laparoscopic bilateral salpingectomies reduce costs and enhance quality-adjusted life-years relative to the two alternative treatments. |
| Databáze: | OpenAIRE |
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