Send to

Choose Destination
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

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



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


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.


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.


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

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central
Loading ...
Support Center