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  1. Cost-effectiveness of cancer screening in end-stage renal disease.

    Article - En anglais


    Limited evidence suggests that persons with end-stage renal disease (ESRD) may be at increased risk for malignancy.

    The appropriateness of screening procedures in this population has not been evaluated.


    To determine the relative cost-effectiveness of hypothetical cancer screening programs in the population with ESRD compared with the general population.


    We performed a cost-effectiveness analysis, employing the declining exponential approximation of life expectancy.

    Assumptions were put forth to bias the model in favor of cancer screening.

    Secondary comparisons were made between cancer screening and other interventions targeted to patients with ESRD.


    The costs per unit of survival benefit conferred by cancer screening were 1.6 to 19.3 times greater among patients with ESRD than in the general population, depending on age, sex, and race, and assumptions outlined herein.

    For persons with ESRD, the net gain in life expectancy from a typical cancer screening program was calculated to be 5 days or less.

    Similar survival gains could be obtained via a reduction of 0.02% or less in the baseline ESRD-related mortality rate.


    These analyses suggest that routine cancer screening in the population with ESRD is a relatively inefficient allocation of financial resources.

    Direction of funds toward improving the quality of dialysis could attain such an objective at substantially lower cost. (...)

    Mots-clés Pascal : Insuffisance rénale, Stade terminal, Tumeur maligne, Analyse coût efficacité, Etats Unis, Amérique du Nord, Amérique, Dépistage, Homme, Appareil urinaire pathologie, Rein pathologie

    Mots-clés Pascal anglais : Renal failure, Terminal stage, Malignant tumor, Cost efficiency analysis, United States, North America, America, Medical screening, Human, Urinary system disease, Renal disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0334023

    Code Inist : 002B14A05. Création : 10/04/1997.