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dc.contributor.authorEccleston, Aen_US
dc.contributor.authorBentley, Aen_US
dc.contributor.authorDyer, Men_US
dc.contributor.authorStrydom, Aen_US
dc.contributor.authorVereecken, Wen_US
dc.contributor.authorGeorge, Aen_US
dc.contributor.authorRahman, Nen_US
dc.coverage.spatialUnited Statesen_US
dc.date.accessioned2018-02-16T09:31:19Z
dc.date.issued2017-04en_US
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/28407998en_US
dc.identifierS1098-3015(17)30064-5en_US
dc.identifier.citationValue Health, 2017, 20 (4), pp. 567 - 576en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1159
dc.identifier.eissn1524-4733en_US
dc.identifier.doi10.1016/j.jval.2017.01.004en_US
dc.description.abstractOBJECTIVES: To evaluate the long-term cost-effectiveness of germline BRCA1 and BRCA2 (collectively termed "BRCA") testing in women with epithelial ovarian cancer, and testing for the relevant mutation in first- and second-degree relatives of BRCA mutation-positive individuals, compared with no testing. Female BRCA mutation-positive relatives of patients with ovarian cancer could undergo risk-reducing mastectomy and/or bilateral salpingo-oophorectomy. METHODS: A cost-effectiveness model was developed that included the risks of breast and ovarian cancer; the costs, utilities, and effects of risk-reducing surgery on cancer rates; and the costs, utilities, and mortality rates associated with cancer. RESULTS: BRCA testing of all women with epithelial ovarian cancer each year is cost-effective at a UK willingness-to-pay threshold of £20,000/quality-adjusted life-year (QALY) compared with no testing, with an incremental cost-effectiveness ratio of £4,339/QALY. The result was primarily driven by fewer cases of breast cancer (142) and ovarian cancer (141) and associated reductions in mortality (77 fewer deaths) in relatives over the subsequent 50 years. Sensitivity analyses showed that the results were robust to variations in the input parameters. Probabilistic sensitivity analysis showed that the probability of germline BRCA mutation testing being cost-effective at a threshold of £20,000/QALY was 99.9%. CONCLUSIONS: Implementing germline BRCA testing in all patients with ovarian cancer would be cost-effective in the United Kingdom. The consequent reduction in future cases of breast and ovarian cancer in relatives of mutation-positive individuals would ease the burden of cancer treatments in subsequent years and result in significantly better outcomes and reduced mortality rates for these individuals.en_US
dc.format.extent567 - 576en_US
dc.languageengen_US
dc.language.isoengen_US
dc.subjectBRCA gene testingen_US
dc.subjectbreast canceren_US
dc.subjectcost-effectivenessen_US
dc.subjectovarian canceren_US
dc.subjectAdulten_US
dc.subjectAgeden_US
dc.subjectBRCA1 Proteinen_US
dc.subjectBRCA2 Proteinen_US
dc.subjectBiomarkers, Tumoren_US
dc.subjectBreast Neoplasmsen_US
dc.subjectCarcinoma, Ovarian Epithelialen_US
dc.subjectComputer Simulationen_US
dc.subjectCost-Benefit Analysisen_US
dc.subjectDNA Mutational Analysisen_US
dc.subjectDecision Support Techniquesen_US
dc.subjectEarly Detection of Canceren_US
dc.subjectFemaleen_US
dc.subjectGenetic Predisposition to Diseaseen_US
dc.subjectGenetic Testingen_US
dc.subjectGerm-Line Mutationen_US
dc.subjectHealth Care Costsen_US
dc.subjectHeredityen_US
dc.subjectHumansen_US
dc.subjectMiddle Ageden_US
dc.subjectModels, Economicen_US
dc.subjectNeoplasms, Glandular and Epithelialen_US
dc.subjectOvarian Neoplasmsen_US
dc.subjectPedigreeen_US
dc.subjectPhenotypeen_US
dc.subjectPredictive Value of Testsen_US
dc.subjectPrognosisen_US
dc.subjectQuality-Adjusted Life Yearsen_US
dc.subjectReproducibility of Resultsen_US
dc.subjectRisk Assessmenten_US
dc.subjectRisk Factorsen_US
dc.subjectTime Factorsen_US
dc.subjectUnited Kingdomen_US
dc.titleA Cost-Effectiveness Evaluation of Germline BRCA1 and BRCA2 Testing in UK Women with Ovarian Cancer.en_US
dc.typeJournal Article
dcterms.dateAccepted2017-01-11en_US
rioxxterms.versionofrecord10.1016/j.jval.2017.01.004en_US
rioxxterms.licenseref.startdate2017-04en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfValue Healthen_US
pubs.issue4en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research/Genetic Susceptibility
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Genetic Susceptibility
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublisheden_US
pubs.volume20en_US
pubs.embargo.termsNot knownen_US
icr.researchteamGenetic Susceptibilityen_US
dc.contributor.icrauthorRahman, Saberaen_US
dc.contributor.icrauthorMarsden,en_US


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