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Economic evaluation of the familial cancer programme in Western Australia: predictive genetic testing for familial adenomatous polyposis and hereditary non-polyposis colorectal carcinoma.
Community Genet. 2006; 9(2):98-106.CG

Abstract

AIM

To evaluate costs and outcomes of genetic testing for familial colorectal cancer through services provided by Genetic Services of Western Australia (GSWA).

METHODS

Costs and outcomes of predictive DNA-based testing for inherited colorectal cancers (CRC) were assessed, specifically for familial adenomatous polyposis (FAP) and hereditary non-polyposis CRC (HNPCC) using a decision-analysis model. Costs were assigned according to standards of care in Western Australia (WA). Cancer risks and the efficacy of surveillance on long-term outcomes were derived from the published literature.

RESULTS

The cost-effectiveness of genetic testing was compared in first-degree relatives of known mutation carriers who have a 50% risk of carrying the mutated gene (intervention group) to individuals with the same risk but who do not undergo a genetic test (control subjects). Compared with control subjects undergoing the same high-level surveillance and surgery, the FAP and HNPCC intervention groups provided total savings of 13,390 US dollars and 14,783-15,460 per person (males-females), respectively. HPNCC mutation carriers also gained 1 CRC-free year. Compared to control subjects having only population surveillance, individuals in the FAP intervention group delayed the onset of CRC by 40 years for a net cost of 9,042 US dollars. Individuals in the HNPCC intervention group delayed the onset of CRC by 8 years at a net cost of 12,141 US dollars for males and 12,596 US dollars for females.

CONCLUSIONS

Genetic testing for familial CRC in WA allows targeted surveillance for mutation carriers, which ensures the efficient use of resources and reduces cancer-related morbidity, if clinical recommendations for intervention are adopted.

Authors+Show Affiliations

Department of Health, Government of Western Australia, Perth, Australia. nikki_reheny@yahoo.com.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16612060

Citation

Breheny, N, et al. "Economic Evaluation of the Familial Cancer Programme in Western Australia: Predictive Genetic Testing for Familial Adenomatous Polyposis and Hereditary Non-polyposis Colorectal Carcinoma." Community Genetics, vol. 9, no. 2, 2006, pp. 98-106.
Breheny N, Geelhoed E, Goldblatt J, et al. Economic evaluation of the familial cancer programme in Western Australia: predictive genetic testing for familial adenomatous polyposis and hereditary non-polyposis colorectal carcinoma. Community Genet. 2006;9(2):98-106.
Breheny, N., Geelhoed, E., Goldblatt, J., Ee, H., & O'Leary, P. (2006). Economic evaluation of the familial cancer programme in Western Australia: predictive genetic testing for familial adenomatous polyposis and hereditary non-polyposis colorectal carcinoma. Community Genetics, 9(2), 98-106.
Breheny N, et al. Economic Evaluation of the Familial Cancer Programme in Western Australia: Predictive Genetic Testing for Familial Adenomatous Polyposis and Hereditary Non-polyposis Colorectal Carcinoma. Community Genet. 2006;9(2):98-106. PubMed PMID: 16612060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Economic evaluation of the familial cancer programme in Western Australia: predictive genetic testing for familial adenomatous polyposis and hereditary non-polyposis colorectal carcinoma. AU - Breheny,N, AU - Geelhoed,E, AU - Goldblatt,J, AU - Ee,H, AU - O'Leary,P, PY - 2006/4/14/pubmed PY - 2006/9/28/medline PY - 2006/4/14/entrez SP - 98 EP - 106 JF - Community genetics JO - Community Genet VL - 9 IS - 2 N2 - AIM: To evaluate costs and outcomes of genetic testing for familial colorectal cancer through services provided by Genetic Services of Western Australia (GSWA). METHODS: Costs and outcomes of predictive DNA-based testing for inherited colorectal cancers (CRC) were assessed, specifically for familial adenomatous polyposis (FAP) and hereditary non-polyposis CRC (HNPCC) using a decision-analysis model. Costs were assigned according to standards of care in Western Australia (WA). Cancer risks and the efficacy of surveillance on long-term outcomes were derived from the published literature. RESULTS: The cost-effectiveness of genetic testing was compared in first-degree relatives of known mutation carriers who have a 50% risk of carrying the mutated gene (intervention group) to individuals with the same risk but who do not undergo a genetic test (control subjects). Compared with control subjects undergoing the same high-level surveillance and surgery, the FAP and HNPCC intervention groups provided total savings of 13,390 US dollars and 14,783-15,460 per person (males-females), respectively. HPNCC mutation carriers also gained 1 CRC-free year. Compared to control subjects having only population surveillance, individuals in the FAP intervention group delayed the onset of CRC by 40 years for a net cost of 9,042 US dollars. Individuals in the HNPCC intervention group delayed the onset of CRC by 8 years at a net cost of 12,141 US dollars for males and 12,596 US dollars for females. CONCLUSIONS: Genetic testing for familial CRC in WA allows targeted surveillance for mutation carriers, which ensures the efficient use of resources and reduces cancer-related morbidity, if clinical recommendations for intervention are adopted. SN - 1422-2795 UR - https://www.unboundmedicine.com/medline/citation/16612060/Economic_evaluation_of_the_familial_cancer_programme_in_Western_Australia:_predictive_genetic_testing_for_familial_adenomatous_polyposis_and_hereditary_non_polyposis_colorectal_carcinoma_ L2 - https://www.karger.com?DOI=10.1159/000091487 DB - PRIME DP - Unbound Medicine ER -