Evidence map›Paper›PMID 33849967›Full record

ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2021

Can Cost-effectiveness Analysis Inform Genotype-Guided Aspirin Use for Primary Colorectal Cancer Prevention?

Eman Biltaji, Brandon Walker, Trang H Au, Zachary Rivers, Jennifer Ose, Christopher I Li, Diana I Brixner, David D Stenehjem, Cornelia M Ulrich

Registry-linked trialOpen access · bronzeAbstract read
In one paragraph

Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02328677 (ColoCare Transdisciplinary Research in Colorectal Cancer Prognosis), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 46% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02328677 recruitingnot on this map

ColoCare Transdisciplinary Research in Colorectal Cancer Prognosis

TypeobservationalSponsorUniversity of UtahRan2007 to 2030Enrolled5,000ConditionsColorectal Cancer
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Eman BiltajiDepartment of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah.ORCID 0000-0003-0215-5842
Brandon WalkerDepartment of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah.
Trang H AuDepartment of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah.ORCID 0000-0002-0149-0115
Zachary RiversDepartment of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota.
Jennifer OseHuntsman Cancer Institute, University of Utah, Salt Lake City, Utah.ORCID 0000-0002-2030-9676
Christopher I LiDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Diana I Brixner *Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah. stene032@d.umn.edu neli.ulrich@hci.utah.edu diana.brixner@utah.edu.
David D Stenehjem *Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah. stene032@d.umn.edu neli.ulrich@hci.utah.edu diana.brixner@utah.edu.ORCID 0000-0002-1831-285X
Cornelia M Ulrich *Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah. stene032@d.umn.edu neli.ulrich@hci.utah.edu diana.brixner@utah.edu.
University of Utah · USAmerican Association of Colleges of Pharmacy · USFred Hutch Cancer Center · US

Funding

University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR002494 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R, WEISDORF, DANIEL J · 2018 to 2022
$34.9M
Transdisciplinary Team Science in Colorectal Cancer Prognosis: the ColoCare StudyU01CA206110 · NCI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Jane C. Figueiredo, Christopher I Li · 2016 to 2026
$18.6M
Discovery and verification of novel biomarkers of colorectal cancer recurrenceR01CA189184 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LI, CHRISTOPHER I, ULRICH, CORNELIA M · 2015 to 2020
$5.6M
Metabolomic Strategies for Discovery and Validation of Biomarkers of Colorectal Cancer RecurrenceR01CA207371 · NCI · UNIVERSITY OF UTAH · PI LI, CHRISTOPHER I, ULRICH, CORNELIA M · 2017 to 2022
$3.9M
NRSA Training CoreTL1TR002493 · NCATS · UNIVERSITY OF MINNESOTA · PI FULKERSON, JAYNE ALLYN · 2018 to 2022
$3.1M
NCATS NIH HHS TL1 TR002493NCATS NIH HHS UL1 TR002494NCI NIH HHS R01 CA189184NCI NIH HHS R01 CA207371NCI NIH HHS U01 CA206110
6 · The paper itself

Abstract

backgroundInherited genetic variants can modify the cancer-chemopreventive effect of aspirin. We evaluated the clinical and economic value of genotype-guided aspirin use for colorectal cancer chemoprevention in average-risk individuals.

methodsA decision analytical model compared genotype-guided aspirin use versus no genetic testing, no aspirin. The model simulated 100,000 adults ≥50 years of age with average colorectal cancer and cardiovascular disease risk. Low-dose aspirin daily starting at age 50 years was recommended only for those with a genetic test result indicating a greater reduction in colorectal cancer risk with aspirin use. The primary outcomes were quality-adjusted life-years (QALY), costs, and incremental cost-effectiveness ratio (ICER).

resultsThe mean cost of using genotype-guided aspirin was $187,109 with 19.922 mean QALYs compared with $186,464 with 19.912 QALYs for no genetic testing, no aspirin. Genotype-guided aspirin yielded an ICER of $66,243 per QALY gained, and was cost-effective in 58% of simulations at the $100,000 willingness-to-pay threshold. Genotype-guided aspirin was associated with 1,461 fewer polyps developed, 510 fewer colorectal cancer cases, and 181 fewer colorectal cancer-related deaths. This strategy prevented 1,078 myocardial infarctions with 1,430 gastrointestinal bleeding events, and 323 intracranial hemorrhage cases compared with no genetic testing, no aspirin.

conclusionsGenotype-guided aspirin use for colorectal cancer chemoprevention may offer a cost-effective approach for the future management of average-risk individuals. IMPACT: A genotype-guided aspirin strategy may prevent colorectal cancer, colorectal cancer-related deaths, and myocardial infarctions, while minimizing bleeding adverse events. This model establishes a framework for genetically-guided aspirin use for targeted chemoprevention of colorectal cancer with application toward commercial testing in this population.

Indexed as

AspirinColorectal NeoplasmsComputer SimulationCost-Benefit AnalysisDose-Response Relationship, DrugFeasibility StudiesGenetic TestingGenotypeHumansMiddle AgedModels, EconomicMyocardial InfarctionPharmacogenomic VariantsPrecision MedicinePrimary PreventionQuality-Adjusted Life YearsAspirin

Identifiers

PMID33849967
PMCPMC8172453
OpenAlexW3156987136

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.