ArticleGenetics in medicine : official journal of the American College of Medical Genetics2020
Cost-effectiveness of long-term clinical management of BRCA pathogenic variant carriers.
Article in Genetics in medicine : official journal of the American College of Medical Genetics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
19 citing papers in PubMed, 27 citations in OpenAlex.
- Expected costs and benefits of genetic counselling and germline genetic testing in metastatic prostate cancer.Human genetics · 2026Article
- Consumer acceptability of a cancer registry-driven familial cancer testing pathway: a qualitative study using the Theoretical Framework of Acceptability.Future oncology (London, England) · 2026Article
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- Reduced Breast and Ovarian Cancer Through Targeted Genetic Testing: Estimates Using the NEEMO Microsimulation Model.Cancers · 2024Article
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- "There should be one spot that you can go:" BRCA mutation carriers' perspectives on cancer risk management and a hereditary cancer registry.Journal of community genetics · 2024Article
- The Difference Method Approach for Sampling Order Constrained Parameters: An Improved Implementation and Important Limitations.PharmacoEconomics · 2024Article
- Ten-Year Follow-Up of Women at High Risk for Familial Breast and Ovarian Cancer in Otago and Southland, New Zealand.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Longitudinal adherence to breast cancer surveillance following cancer genetic testing in an integrated health care system.Breast cancer research and treatment · 2023Article
- Evaluation of disparities in perceived healthcare discrimination amongWomen & health · 2023Article
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- A cost-utility analysis ofFrontiers in public health · 2023Article
- Germline BRCA testing in pancreatic cancer: improving awareness, timing, turnaround, and uptake.Therapeutic advances in medical oncology · 2023Review
- Cost-Effectiveness of Risk-Reducing Surgery for Breast and Ovarian Cancer Prevention: A Systematic Review.Cancers · 2022Review
- Article
- Surgical Management of Hereditary Breast Cancer.Genes · 2021Review
- Management of patients with BRCA mutation from the point of view of a breast surgeon.Annals of medicine and surgery (2012) · 2021Review
- Why is appropriate healthcare inaccessible for many European breast cancer patients? - The EBCC 12 manifesto.Breast (Edinburgh, Scotland) · 2021Article
- Clinical Genetic Screening in Adult Patients with Kidney Disease.Clinical journal of the American Society of Nephrology : CJASN · 2020Review
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWomen who inherit a BRCA1 or BRCA2 pathogenic variant are at high risk of developing breast and ovarian cancer. Evidence for the effectiveness and cost-effectiveness of long-term management in clinical practice is lacking. The purpose of this study was to evaluate the real-world cost-effectiveness of BRCA carrier management within a structured clinical program.
methodsLifetime health outcomes and costs of clinical management for female unaffected BRCA carriers aged 20 were measured using a microsimulation model. For the intervention, women could attend a high-risk clinic, undergo risk-reducing surgery, and receive annual breast screening. Input data for the model was from a clinical database of 983 BRCA carriers. The comparator was no risk management. Outcomes were discounted at 5%.
resultsThe incremental cost-effectiveness ratio for the program was $32,359 to $48,263 per quality-adjusted life-year (QALY). Limiting uptake of risk-reducing salpingo-oophorectomy to <50% of carriers decreased cost-effectiveness by $7000-8000 per QALY. Achieving perfect adherence to guidelines was less cost-effective for BRCA2 due to increased risk-reducing mastectomy costs with smaller incremental health benefit.
conclusionLong-term management of BRCA carriers within a structured clinical program is cost-effective. Suboptimal adherence to risk management guidelines can substantially affect outcomes and is an important consideration for future studies.
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