A cost-effectiveness analysis of colorectal screening of hereditary nonpolyposis colorectal carcinoma gene carriers.
It has been estimated that the prevalence of carriers of a mutated mismatch repair (MMR) gene among the general population in Western countries is between 5 and 50 per 10,000.
These carriers have a risk of>85% of developing colorectal carcinoma (CRC) and therefore need careful follow-up.
The objective of this study was to analyze the cost-effectiveness of CRC surveillance of carriers of a mutated MMR gene.
The authors constructed a model to estimate the potential health effects (life expectancy) and healthcare costs of two strategies : 1) surveillance, with colonoscopy every 2-3 years, and 2) no CRC surveillance.
Estimates of the lifetime risk of developing CRC and the stage distribution of CRC for symptomatic patients were derived from the Dutch hereditary nonpolyposis colorectal carcinoma (HNPCC) registry.
The CRC stage specific relative survival rates and the effectiveness of surveillance in preventing or detecting cancer early were based on Finnish studies.
The costs of surveillance and treatment were derived from recent American studies.
The results showed that 1) surveillance of gene carriers led to an increase in life expectancy of 7 years, and 2) the costs of surveillance under a wide range of assumptions are less than the costs of no CRC surveillance. (...)
Mots-clés Pascal : Carcinome, Côlon, Rectum, Héréditaire, Mutation, Gène, Dépistage, Analyse coût efficacité, Surveillance, Arbre décision, Economie santé, Pays Bas, Europe, Homme, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie, Maladie héréditaire, Porteur sain
Mots-clés Pascal anglais : Carcinoma, Colon, Rectum, Hereditary, Mutation, Gene, Medical screening, Cost efficiency analysis, Surveillance, Decision tree, Health economy, Netherlands, Europe, Human, Malignant tumor, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease, Genetic disease, Healthy carrier
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0234737
Code Inist : 002B13B01. Création : 11/09/1998.