PMID- 15138471
OWN - NLM
STAT- MEDLINE
DCOM- 20040616
LR  - 20220309
IS  - 0007-0920 (Print)
IS  - 1532-1827 (Electronic)
IS  - 0007-0920 (Linking)
VI  - 90
IP  - 10
DP  - 2004 May 17
TI  - Estimating the survival benefits gained from providing national cancer genetic 
      services to women with a family history of breast cancer.
PG  - 1912-9
AB  - The aim of this paper is to compare a service offering genetic testing and 
      presymptomatic surveillance to women at increased risk of developing breast 
      cancer with its predecessor of no service at all in terms of survival and 
      quality-adjusted survival (QALYs) by means of a Markov cohort chain simulation 
      model. Genetic assessment and presymptomatic care provided between 0.07-1.61 mean 
      additional life years and 0.05-1.67 mean QALYs over no services. Prophylactic 
      surgery and surveillance extended mean life expectancy by 0.41-1.61 and 0.32-0.99 
      years, respectively over no services for high-risk women. Model outcomes were 
      sensitive to all the parameters varied in the sensitivity analysis. Providing 
      cancer genetic services increase survival and as long as services do not induce 
      adverse psychological effects they also provide more QALYs. The greatest survival 
      and QALY benefits were found for women with identified mutations. As more cancer 
      genes are identified, the survival and cost-effectiveness of genetic services 
      will improve. Although mastectomy provided most additional life years, when 
      quality of life was accounted for oophorectomy was the optimal strategy. Delayed 
      entry into coordinated genetic services was found to diminish the average 
      survival and QALY gains for a woman utilising these services.
FAU - Griffith, G L
AU  - Griffith GL
AD  - Centre for the Economics of Health, Institute of Medical and Social Care 
      Research, University of Wales, Bangor, Gwynedd LL57 2UW, UK. 
      g.griffith@bangor.ac.uk
FAU - Edwards, R T
AU  - Edwards RT
FAU - Gray, J
AU  - Gray J
FAU - Wilkinson, C
AU  - Wilkinson C
FAU - Turner, J
AU  - Turner J
FAU - France, B
AU  - France B
FAU - Bennett, P
AU  - Bennett P
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Br J Cancer
JT  - British journal of cancer
JID - 0370635
SB  - IM
MH  - Adult
MH  - Aged
MH  - Breast Neoplasms/*genetics/*pathology/surgery
MH  - Cohort Studies
MH  - Female
MH  - *Genetic Predisposition to Disease
MH  - *Genetic Testing
MH  - Humans
MH  - Markov Chains
MH  - Mastectomy
MH  - Middle Aged
MH  - *Models, Theoretical
MH  - Ovariectomy
MH  - Pedigree
MH  - *Quality-Adjusted Life Years
MH  - Survival Analysis
PMC - PMC2409461
EDAT- 2004/05/13 05:00
MHDA- 2004/06/17 05:00
PMCR- 2005/04/20
CRDT- 2004/05/13 05:00
PHST- 2004/05/13 05:00 [pubmed]
PHST- 2004/06/17 05:00 [medline]
PHST- 2004/05/13 05:00 [entrez]
PHST- 2005/04/20 00:00 [pmc-release]
AID - 6601794 [pii]
AID - 10.1038/sj.bjc.6601794 [doi]
PST - ppublish
SO  - Br J Cancer. 2004 May 17;90(10):1912-9. doi: 10.1038/sj.bjc.6601794.