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Genet Med. 2003 Sep-Oct;5(5):353-63.

An economic viewpoint on alternative strategies for identifying persons with hereditary nonpolyposis colorectal cancer.

Author information

1
Fred Hutchinson Cancer Research Center, and Department of Medicine, University of Washington, Seattle, Washington, USA.

Abstract

PURPOSE:

There is uncertainty regarding the optimal strategy for identifying mutation carriers among those with hereditary nonpolyposis colorectal cancer (HNPCC).

METHODS:

We used decision analysis to compare the cost-effectiveness of 4 strategies among those with newly diagnosed colon cancer: (1) clinical and family history followed by microsatellite instability testing and germline testing (Bethesda guidelines); (2) universal microsatellite instability testing; (3) germline testing of those who meet clinical and family history criteria; and (4) universal germline testing.

RESULTS:

The added cost per year of life saved (YLS) for each strategy was as follows: (1) 11,865 US dollars/YLS, (2) 35,617 US dollars/YLS, (3) 49,702 US dollars/YLS, and (4) 267,548 US dollars/YLS.

CONCLUSIONS:

The Bethesda guidelines are the most cost-effectiveness approach to screen persons for HNPCC.

[Indexed for MEDLINE]
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