ArticleBritish journal of cancer2004
Estimating the survival benefits gained from providing national cancer genetic services to women with a family history of breast cancer.
Article in British journal of cancer, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cost-effectiveness and comparative effectiveness of cancer risk management strategies in BRCA1/2 mutation carriers: a systematic review.Genetics in medicine : official journal of the American College of Medical Genetics · 2018Pooled it
- Cost-effectiveness analysis of a low-fat diet in the prevention of breast and ovarian cancer.Journal of the American Dietetic Association · 2011Article
- Clinical genetics issues encountered by family physicians.Genetics in medicine : official journal of the American College of Medical Genetics · 2005Article
- A pharmacoeconomic analysis from Italian guidelines for the management of prolactinomas.Global & regional health technology assessmentArticle
- Micro-costing analysis from Italian Guidelines for the management of sporadic primary hyperparathyroidism.Global & regional health technology assessmentArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this paper is to compare a service offering genetic testing and presymptomatic surveillance to women at increased risk of developing breast cancer with its predecessor of no service at all in terms of survival and quality-adjusted survival (QALYs) by means of a Markov cohort chain simulation model. Genetic assessment and presymptomatic care provided between 0.07-1.61 mean additional life years and 0.05-1.67 mean QALYs over no services. Prophylactic surgery and surveillance extended mean life expectancy by 0.41-1.61 and 0.32-0.99 years, respectively over no services for high-risk women. Model outcomes were sensitive to all the parameters varied in the sensitivity analysis. Providing cancer genetic services increase survival and as long as services do not induce adverse psychological effects they also provide more QALYs. The greatest survival and QALY benefits were found for women with identified mutations. As more cancer genes are identified, the survival and cost-effectiveness of genetic services will improve. Although mastectomy provided most additional life years, when quality of life was accounted for oophorectomy was the optimal strategy. Delayed entry into coordinated genetic services was found to diminish the average survival and QALY gains for a woman utilising these services.
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