Cost-Effectiveness Analysis of Molecular Screening to Identify Lynch Syndrome in the Patients with Colorectal Cancer

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Azardoost Hananeh; RAHIMI FARIMAH; ZEINALIAN MEHRDAD; REZAYATMAND REZA

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Journal Paper

Paper Information

Journal: International Journal of Cancer Management Year:2021 | Volume:14 | Issue:4 Page(s): 0-0

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Title

Cost-Effectiveness Analysis of Molecular Screening to Identify Lynch Syndrome in the Patients with Colorectal Cancer

Author(s)

Azardoost Hananeh | RAHIMI FARIMAH | ZEINALIAN MEHRDAD | REZAYATMAND REZA | Issue Writer Certificate

Keywords

Cost-Effectiveness

Colorectal Cancer

Lynch Syndrome

Screening

Iran

Abstract

Background: Identifying Lynch Syndrome (LS) in patients with Colorectal Cancer (CRC) and monitoring their relatives can increase the life expectancy of these patients. Objectives: The aim of this study was to analyze the Cost-Effectiveness of 5 molecular testing strategies to screen LS among patients with newly diagnosed CRC and to conduct preventive surveillance in their first-degree relatives. Methods: A decision tree model was designed to identify the number of LS mutations and the related costs in the CRC patients. Five strategies were modeled, i. e., Amsterdam II criteria, microsatellite instability (MSI) testing, immunohistochemistry (IHC), and next-generation sequencing (NGS). A Markov model was also used to estimate the long-term outcome of monitoring (including colonoscopy and taking aspirin) among relatives of those patients with CRC who carried LS. Results: All strategies were cost-effective compared with no testing condition. The 2 most cost-effective strategies were strategy 2 (IHC testing followed by NGS testing) and strategy 4 (MSI testing followed by NGS testing), with the ICER of 4, 604$ and 4, 748$ per quality-adjusted life year (QALY), respectively. Based on one-way sensitivity analysis of IHC sensitivity, the Cost of colonoscopy, MSI sensitivity, and the number of families who inherited LS had the most effect on the results. Conclusions: The findings suggested that from an Iranian health care system perspective, IHC testing followed byNGStesting could be regarded as the most cost-effective strategy compared to the other strategies. These results can be useful in offering to screen LS in newly diagnosed CRC patients.

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APA: Copy

Azardoost, Hananeh, RAHIMI, FARIMAH, ZEINALIAN, MEHRDAD, & REZAYATMAND, REZA. (2021). Cost-Effectiveness Analysis of Molecular Screening to Identify Lynch Syndrome in the Patients with Colorectal Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT (IRANIAN JOURNAL OF CANCER PREVENTION), 14(4), 0-0. SID. https://sid.ir/paper/692800/en

Vancouver: Copy

Azardoost Hananeh, RAHIMI FARIMAH, ZEINALIAN MEHRDAD, REZAYATMAND REZA. Cost-Effectiveness Analysis of Molecular Screening to Identify Lynch Syndrome in the Patients with Colorectal Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT (IRANIAN JOURNAL OF CANCER PREVENTION)[Internet]. 2021;14(4):0-0. Available from: https://sid.ir/paper/692800/en

IEEE: Copy

Hananeh Azardoost, FARIMAH RAHIMI, MEHRDAD ZEINALIAN, and REZA REZAYATMAND, “Cost-Effectiveness Analysis of Molecular Screening to Identify Lynch Syndrome in the Patients with Colorectal Cancer,” INTERNATIONAL JOURNAL OF CANCER MANAGEMENT (IRANIAN JOURNAL OF CANCER PREVENTION), vol. 14, no. 4, pp. 0–0, 2021, [Online]. Available: https://sid.ir/paper/692800/en

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