Swiss cost-effectiveness analysis of universal screening for Lynch syndrome of patients with colorectal cancer followed by cascade genetic testing of relatives

Salikhanov, Islam; Heinimann, Karl; Chappuis, Pierre; Buerki, Nicole; Graffeo, Rossella; Heinzelmann, Viola; Rabaglio, Manuela; Taborelli, Monica; Wieser, Simon; Katapodi, Maria C.

doi:10.1136/jmedgenet-2021-108062

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-24638

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 10.21256/zhaw-24638
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 1468-6244
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.
URI:	https://digitalcollection.zhaw.ch/handle/11475/24638
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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Salikhanov, I., Heinimann, K., Chappuis, P., Buerki, N., Graffeo, R., Heinzelmann, V., Rabaglio, M., Taborelli, M., Wieser, S., & Katapodi, M. C. (2021). Swiss cost-effectiveness analysis of universal screening for Lynch syndrome of patients with colorectal cancer followed by cascade genetic testing of relatives. Journal of Medical Genetics, 59(9), 924–930. https://doi.org/10.1136/jmedgenet-2021-108062

Salikhanov, I. et al. (2021) ‘Swiss cost-effectiveness analysis of universal screening for Lynch syndrome of patients with colorectal cancer followed by cascade genetic testing of relatives’, Journal of Medical Genetics, 59(9), pp. 924–930. Available at: https://doi.org/10.1136/jmedgenet-2021-108062.

I. Salikhanov et al., “Swiss cost-effectiveness analysis of universal screening for Lynch syndrome of patients with colorectal cancer followed by cascade genetic testing of relatives,” Journal of Medical Genetics, vol. 59, no. 9, pp. 924–930, Nov. 2021, doi: 10.1136/jmedgenet-2021-108062.

SALIKHANOV, Islam, Karl HEINIMANN, Pierre CHAPPUIS, Nicole BUERKI, Rossella GRAFFEO, Viola HEINZELMANN, Manuela RABAGLIO, Monica TABORELLI, Simon WIESER und Maria C. KATAPODI, 2021. Swiss cost-effectiveness analysis of universal screening for Lynch syndrome of patients with colorectal cancer followed by cascade genetic testing of relatives. Journal of Medical Genetics. 15 November 2021. Bd. 59, Nr. 9, S. 924–930. DOI 10.1136/jmedgenet-2021-108062

Salikhanov, Islam, Karl Heinimann, Pierre Chappuis, Nicole Buerki, Rossella Graffeo, Viola Heinzelmann, Manuela Rabaglio, Monica Taborelli, Simon Wieser, and Maria C. Katapodi. 2021. “Swiss Cost-Effectiveness Analysis of Universal Screening for Lynch Syndrome of Patients with Colorectal Cancer Followed by Cascade Genetic Testing of Relatives.” Journal of Medical Genetics 59 (9): 924–30. https://doi.org/10.1136/jmedgenet-2021-108062.

Salikhanov, Islam, et al. “Swiss Cost-Effectiveness Analysis of Universal Screening for Lynch Syndrome of Patients with Colorectal Cancer Followed by Cascade Genetic Testing of Relatives.” Journal of Medical Genetics, vol. 59, no. 9, Nov. 2021, pp. 924–30, https://doi.org/10.1136/jmedgenet-2021-108062.