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| Description
| - BACKGROUND: The hereditary syndrome (BRCA1/BRCA2 mutations) causes 5–7% of diagnosed breast cancer. In Czech Republic, patients suspected of this gene alteration undergo DNA testing, and the whole family joins screening programs. They will eventually become ill with a high probability (predicted breast cancer risk in women with BRCA1/BRCA2 mutation being 78-83% by the age of 70), however, the screening can detect cancer in earlier stages. The screening program has run only for 10 years comprising 105 patients, 10 diagnosed with breast cancer. Although the outcome in these women was better than in the general population, cost/QALY appeared higher for preventive programs. The reasons might have been the size of the sample. OBJECTIVE: To assess cost effectiveness of hereditary breast cancer prevention as standard care in family members of diagnosed patients. METHODS: Due to the lack of clinical data, calculations were repeated using a cohort of patients generated by the Monte-Carlo method. A fictional cohort of 331 women (164 with BRCA1 and 167 with BRCA2) was generated on the grounds of published data (Klijn JGM. Eur J Cancer Suppl 2003;1:13-23). This cohort was used to estimate average cost of the screening program per one woman (CZK127,504). Treatment costs were calculated by the micro-costing method from real data. RESULTS: The costs/QALY ratio amounted to CZK523,065 in general population, CZK788,562 in women from the preventive program. This seems to confirm the pilot results. However, in the preventive program there are also women after treatment of (any) malignancy, and women translated from other clinics. Excluding these cases, the CE ratio decreases to CZK388,962. Hence, the results might rather point at ineffective screening programs in regional mammary centers, where many women are included unnecessarily, while other suspected women are not sent to genetic tests to specialized clinics, than speak about ineffectiveness of the preventive program as such
- BACKGROUND: The hereditary syndrome (BRCA1/BRCA2 mutations) causes 5–7% of diagnosed breast cancer. In Czech Republic, patients suspected of this gene alteration undergo DNA testing, and the whole family joins screening programs. They will eventually become ill with a high probability (predicted breast cancer risk in women with BRCA1/BRCA2 mutation being 78-83% by the age of 70), however, the screening can detect cancer in earlier stages. The screening program has run only for 10 years comprising 105 patients, 10 diagnosed with breast cancer. Although the outcome in these women was better than in the general population, cost/QALY appeared higher for preventive programs. The reasons might have been the size of the sample. OBJECTIVE: To assess cost effectiveness of hereditary breast cancer prevention as standard care in family members of diagnosed patients. METHODS: Due to the lack of clinical data, calculations were repeated using a cohort of patients generated by the Monte-Carlo method. A fictional cohort of 331 women (164 with BRCA1 and 167 with BRCA2) was generated on the grounds of published data (Klijn JGM. Eur J Cancer Suppl 2003;1:13-23). This cohort was used to estimate average cost of the screening program per one woman (CZK127,504). Treatment costs were calculated by the micro-costing method from real data. RESULTS: The costs/QALY ratio amounted to CZK523,065 in general population, CZK788,562 in women from the preventive program. This seems to confirm the pilot results. However, in the preventive program there are also women after treatment of (any) malignancy, and women translated from other clinics. Excluding these cases, the CE ratio decreases to CZK388,962. Hence, the results might rather point at ineffective screening programs in regional mammary centers, where many women are included unnecessarily, while other suspected women are not sent to genetic tests to specialized clinics, than speak about ineffectiveness of the preventive program as such (en)
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| Title
| - Gene screening and prevention of hereditary breast cancer: a cost-effectiveness Monte-Carlo study
- Gene screening and prevention of hereditary breast cancer: a cost-effectiveness Monte-Carlo study (en)
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| skos:prefLabel
| - Gene screening and prevention of hereditary breast cancer: a cost-effectiveness Monte-Carlo study
- Gene screening and prevention of hereditary breast cancer: a cost-effectiveness Monte-Carlo study (en)
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| skos:notation
| - RIV/68407700:21460/13:00205725!RIV14-MZ0-21460___
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| http://linked.open...avai/riv/aktivita
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| http://linked.open...avai/riv/aktivity
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| http://linked.open...vai/riv/dodaniDat
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| http://linked.open...aciTvurceVysledku
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| http://linked.open.../riv/druhVysledku
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| http://linked.open...iv/duvernostUdaju
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| http://linked.open...titaPredkladatele
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| http://linked.open...dnocenehoVysledku
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| http://linked.open...ai/riv/idVysledku
| - RIV/68407700:21460/13:00205725
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| http://linked.open...riv/jazykVysledku
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| http://linked.open.../riv/klicovaSlova
| - breast cancer; BRCA; HTA; cost effectiveness; CEA (en)
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| http://linked.open.../riv/klicoveSlovo
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| http://linked.open...ontrolniKodProRIV
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| http://linked.open...in/vavai/riv/obor
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| http://linked.open...ichTvurcuVysledku
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| http://linked.open...cetTvurcuVysledku
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| http://linked.open...vavai/riv/projekt
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| http://linked.open...UplatneniVysledku
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| http://linked.open...iv/tvurceVysledku
| - Rogalewicz, Vladimír
- Šinkorová, Veronika
- Kotajná, Kateřina
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| http://localhost/t...ganizacniJednotka
| |
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