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Cost-effectiveness of routine screening for Lynch syndrome in endometrial cancer patients up to 70years of age.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2016 Dec; Vol. 143 (3), pp. 453-459. Date of Electronic Publication: 2016 Oct 24. - Publication Year :
- 2016
-
Abstract
- Purpose: To assess cost-effectiveness of routine screening for Lynch Syndrome (LS) in endometrial cancer (EC) patients ≤70years of age.<br />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.<br />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 <€16,000/LYG in sensitivity analyses.<br />Conclusion: Routine LS screening in EC patients ≤70years is a cost-effective strategy, allowing colorectal cancer prevention in EC patients and their relatives.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Age Factors
Aged
Colorectal Neoplasms diagnosis
Cost-Benefit Analysis
DNA Mutational Analysis
Early Detection of Cancer
Family
Female
Genetic Counseling economics
Humans
Immunohistochemistry
Lynch Syndrome II genetics
Mass Screening
Middle Aged
MutL Protein Homolog 1 genetics
DNA Methylation
DNA Mismatch Repair genetics
Endometrial Neoplasms genetics
Genetic Testing economics
Lynch Syndrome II diagnosis
Microsatellite Instability
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 143
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 27789085
- Full Text :
- https://doi.org/10.1016/j.ygyno.2016.10.008