Cost-effectiveness of routine screening for Lynch syndrome in endometrial cancer patients up to 70 years of age

Autor: Carli M. J. Tops, Ans M.W. van den Ouweland, Anne Goverde, Ewout W. Steyerberg, Judith de Waard, Marco J. Bruno, Robert F. Hoedemaeker, Sjarlot G. Kooi, Anja Wagner, Hendrikus J. Dubbink, Helena C. van Doorn, Manon C.W. Spaander, Winand N.M. Dinjens, Robert M.W. Hofstra, Esther W. de Bekker-Grob
Přispěvatelé: Clinical Genetics, Gastroenterology & Hepatology, Obstetrics & Gynecology, Pathology, Public Health
Rok vydání: 2016
Předmět:
Adult
0301 basic medicine
medicine.medical_specialty
Cost effectiveness
Cost-Benefit Analysis
DNA Mutational Analysis
Genetic Counseling
Health benefits
MLH1
DNA Mismatch Repair
03 medical and health sciences
0302 clinical medicine
SDG 3 - Good Health and Well-being
Internal medicine
medicine
Humans
Mass Screening
Family
Genetic Testing
Early Detection of Cancer
Aged
Gynecology
Routine screening
business.industry
Endometrial cancer
Colorectal Cancer Prevention
Age Factors
Obstetrics and Gynecology
Microsatellite instability
DNA Methylation
Middle Aged
medicine.disease
Immunohistochemistry
Lynch syndrome
Endometrial Neoplasms
Lynch Syndrome II
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Female
Microsatellite Instability
Colorectal Neoplasms
MutL Protein Homolog 1
business
Zdroj: Gynecologic Oncology, 143(3), 453-459. Academic Press
ISSN: 0090-8258
Popis: Purpose To assess cost-effectiveness of routine screening for Lynch Syndrome (LS) in endometrial cancer (EC) patients ≤70years of age. Methods Consecutive EC patients ≤70years of age were screened for LS by analysis of microsatellite instability, immunohistochemistry and MLH1 hypermethylation. Costs and health benefit in life years gained (LYG) included surveillance for LS carriers among EC patients and relatives. We calculated incremental cost-effectiveness ratios (ICERs) comparing LS screening among EC patients ≤70years with ≤50years and the revised Bethesda guidelines. Results Screening for LS in 179 EC patients identified 7 LS carriers; 1 was ≤50 and 6 were 51-70years. Per age category 18 and 9 relatives were identified as LS carrier. Screening resulted in 74,7 LYG (45,4 and 29,3 LYG per age category). The ICER for LS screening in EC patients ≤70 compared with ≤50years was €5,252/LYG. The revised Bethesda guidelines missed 4/7 (57%) LS carriers among EC patients. The ICER for LS screening in EC patients ≤70years of age compared with the revised Bethesda guidelines was €6,668/LYG. Both ICERs remained Conclusion Routine LS screening in EC patients ≤70years is a cost-effective strategy, allowing colorectal cancer prevention in EC patients and their relatives.
Databáze: OpenAIRE
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