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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Swiss cost-effectiveness analysis of universal screening for Lynch syndrome of patients with colorectal cancer followed by cascade genetic testing of relatives
Authors: Salikhanov, Islam
Heinimann, Karl
Chappuis, Pierre
Buerki, Nicole
Graffeo, Rossella
Heinzelmann, Viola
Rabaglio, Manuela
Taborelli, Monica
Wieser, Simon
Katapodi, Maria C.
et. al: No
DOI: 10.1136/jmedgenet-2021-108062
Published in: Journal of Medical Genetics
Volume(Issue): 59
Issue: 9
Page(s): 924
Pages to: 930
Issue Date: 15-Nov-2021
Publisher / Ed. Institution: BMJ Publishing Group
ISSN: 0022-2593
Language: English
Subjects: Cost and cost analysis; Gastrointestinal disease; Genetic counseling; Genetic testing; Health care economic and organization
Subject (DDC): 362.1041: Health economics
616: Internal medicine and diseases
Abstract: Background: We estimated the cost-effectiveness of universal DNA screening for Lynch syndrome (LS) among newly diagnosed patients with colorectal cancer (CRC) followed by cascade screening of relatives from the Swiss healthcare system perspective. Methods: We integrated decision trees with Markov models to calculate incremental cost per quality-adjusted life-year saved by screening all patients with CRC (alternative strategy) compared with CRC tumour-based testing followed by DNA sequencing (current strategy). Results: The alternative strategy has an incremental cost-effectiveness ratio of CHF65 058 compared with the current strategy, which is cost-effective according to Swiss standards. Based on annual incidence of CRC in Switzerland, universal DNA screening correctly identifies all 123 patients with CRC with LS, prevents 17 LS deaths and avoids 19 CRC cases, while the current strategy leads to 32 false negative results and 253 LS cases lost to follow-up. One way and probabilistic sensitivity analyses showed that universal DNA testing is cost-effective in around 80% of scenarios, and that the cost of DNA testing and the number of invited relatives per LS case determine the cost-effectiveness ratio. Conclusion: Results can inform policymakers, healthcare providers and insurance companies about the costs and benefits associated with universal screening for LS and cascade genetic testing of relatives.
Fulltext version: Published version
License (according to publishing contract): CC BY 4.0: Attribution 4.0 International
Departement: School of Management and Law
Organisational Unit: Winterthur Institute of Health Economics (WIG)
Appears in collections:Publikationen School of Management and Law

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