Cost-effectiveness of population-based BRCA1/2 testing and ovarian cancer prevention for Ashkenazi Jews: A call for dialogue |
| |
Institution: | 1. From the Center for Medical Genetics, NorthShore University HealthSystem, Evanston;;2. Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago;;3. The Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Evanston;;4. Department of Statistics, Northwestern University, Evanston;;5. Department of Medicine, University of Chicago, Chicago;;6. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. |
| |
Abstract: | PurposeAbout half of unaffected BRCA1/2 carriers have a negative family history, confounding efforts toward presymptomatic carrier identification. Ovarian cancer is preventable for known carriers but is otherwise highly lethal. Cost-effectiveness and gains in life expectancy are important factors in evaluating the desirability of population-based genetic screening, currently the only viable strategy to identify carriers with unrevealing family histories.MethodsCost-utility analysis for a population-based genetic screening program offered to American Ashkenazi Jewish women aged 35–55 years measuring cancer incidence, life expectancy, and cost.ResultsOur model predicts that a genetic screening program would result in 2811 fewer cases of ovarian cancer, with a life expectancy gain of 1.83 quality-adjusted life years among carriers. At a cost of $460 for founder mutation testing, the cost of the program is $8300 (discounted) per year of quality-adjusted life gained.ConclusionIn populations with a high prevalence of BRCA1/2 founder mutations, genetic screening may be cost-effective when compared with recommended public health interventions such as mammographic screening. We advocate the initiation of a dialogue among Jewish stakeholders, genetics professionals, and public health leaders to determine whether a population-based BRCA1/2 genetic screening program should be pursued. |
| |
Keywords: | |
本文献已被 ScienceDirect 等数据库收录! |
|