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Cost-effectiveness of routine screening for Lynch syndrome in endometrial cancer patients up to 70years of age.
Goverde, Anne; Spaander, Manon Cw; van Doorn, Helena C; Dubbink, Hendrikus J; van den Ouweland, Ans Mw; Tops, Carli M; Kooi, Sjarlot G; de Waard, Judith; Hoedemaeker, Robert F; Bruno, Marco J; Hofstra, Robert Mw; de Bekker-Grob, Esther W; Dinjens, Winand Nm; Steyerberg, Ewout W; Wagner, Anja.
Afiliação
  • Goverde A; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • Spaander MC; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • van Doorn HC; Department of Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • Dubbink HJ; Department of Pathology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • van den Ouweland AM; Department of Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • Tops CM; Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
  • Kooi SG; Department of Gynaecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
  • de Waard J; Department of Gynaecology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
  • Hoedemaeker RF; Pathology Laboratory Pathan, Rotterdam, The Netherlands.
  • Bruno MJ; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • Hofstra RM; Department of Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • de Bekker-Grob EW; Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • Dinjens WN; Department of Pathology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • Steyerberg EW; Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
  • Wagner A; Department of Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: a.wagner@erasmusmc.nl.
Gynecol Oncol ; 143(3): 453-459, 2016 Dec.
Article em En | MEDLINE | ID: mdl-27789085
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 <€16,000/LYG in sensitivity analyses. CONCLUSION: Routine LS screening in EC patients ≤70years is a cost-effective strategy, allowing colorectal cancer prevention in EC patients and their relatives.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Testes Genéticos / Neoplasias do Endométrio / Metilação de DNA / Instabilidade de Microssatélites / Reparo de Erro de Pareamento de DNA / Síndrome de Lynch II Tipo de estudo: Diagnostic_studies / Health_economic_evaluation / Prognostic_studies / Screening_studies Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Testes Genéticos / Neoplasias do Endométrio / Metilação de DNA / Instabilidade de Microssatélites / Reparo de Erro de Pareamento de DNA / Síndrome de Lynch II Tipo de estudo: Diagnostic_studies / Health_economic_evaluation / Prognostic_studies / Screening_studies Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article