Details
- Autor(en) / Beteiligte
- Titel
- Cost-effectiveness analysis of reflex testing for Lynch syndrome in women with endometrial cancer in the UK setting
- Ist Teil von
- PloS one, 2019-08, Vol.14 (8), p.e0221419-e0221419
- Ort / Verlag
- United States: Public Library of Science
- Erscheinungsjahr
- 2019
- Link zum Volltext
- Quelle
- Free E-Journal (出版社公開部分のみ）
- Beschreibungen/Notizen
- Lynch syndrome is a hereditary cancer syndrome caused by constitutional pathogenic variants in the DNA mismatch repair (MMR) system, leading to increased risk of colorectal, endometrial and other cancers. The study aimed to identify the incremental costs and consequences of strategies to identify Lynch syndrome in women with endometrial cancer. A decision-analytic model was developed to evaluate the relative cost-effectiveness of reflex testing strategies for identifying Lynch syndrome in women with endometrial cancer taking the NHS perspective and a lifetime horizon. Model input parameters were sourced from various published sources. Consequences were measured using quality-adjusted life years (QALYs). A cost-effectiveness threshold of £20 000/QALY was used. Reflex testing for Lynch syndrome using MMR immunohistochemistry and MLH1 methylation testing was cost-effective versus no testing, costing £14 200 per QALY gained. There was uncertainty due to parameter imprecision, with an estimated 42% chance this strategy is not cost-effective compared with no testing. Age had a significant impact on cost-effectiveness, with testing not predicted to be cost-effective in patients aged 65 years and over. Testing for Lynch syndrome in younger women with endometrial cancer using MMR immunohistochemistry and MLH1 methylation testing may be cost-effective. Age cut-offs may be controversial and adversely affect implementation.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 1932-6203eISSN: 1932-6203DOI: 10.1371/journal.pone.0221419Titel-ID: cdi_plos_journals_2282979898
- Format
- –
- Schlagworte
- Adult, Age, Age Factors, Aged, Analysis, Biology, Biology and Life Sciences, Cancer, Cancer research, Colorectal cancer, Colorectal Neoplasms, Hereditary Nonpolyposis - complications, Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis, Colorectal Neoplasms, Hereditary Nonpolyposis - economics, Colorectal Neoplasms, Hereditary Nonpolyposis - genetics, Complications and side effects, Cost analysis, Cost benefit analysis, Decision analysis, Deoxyribonucleic acid, Diagnosis, DNA, DNA Mismatch Repair - genetics, DNA repair, Endometrial cancer, Endometrial Neoplasms - complications, Endometrial Neoplasms - diagnosis, Endometrial Neoplasms - economics, Endometrial Neoplasms - genetics, Endometrium, Female, Genetic Testing - economics, Genetics, Health aspects, Health care costs, Health risks, Humans, Immunohistochemistry, Management, Mathematical models, Medical care, Cost of, Medicine and Health Sciences, Methylation, Microsatellite Instability, Middle Aged, Mismatch repair, MLH1 protein, Mortality, Mutation, Parameter estimation, Parameter uncertainty, Physical Sciences, Population, Quality-Adjusted Life Years, Reflex - genetics, Research and Analysis Methods, Risk factors, Social Sciences, Surveillance, Systematic review, United Kingdom - epidemiology, Uterine cancer, Women, Women's health