Modelling the benefits of early diagnosis of pancreatic cancer using a biomarker signature.
(2013) In International Journal of Cancer 133(10). p.2392-2397- Abstract
- Pancreatic cancer (PC) has a poor prognosis, with a 5-year survival of 3-4%. This is mainly due to late diagnosis because of diffuse symptoms, where 80-85% of the patients are inoperable. Consequently, early diagnosis would be of significant benefit, resulting in a potential 5-year survival of 30-40%. However, new technologies must be carefully evaluated concerning effectiveness and healthcare costs. We have developed a framework for modelling cost and health effects from early detection of PC, which for the first time allowed us to analyse its cost-effectiveness. A probabilistic cohort model for estimating costs and quality adjusted life-years (QALY) arising from screening for PC, compared to a "wait-and-see"-approach, was designed. The... (More)
- Pancreatic cancer (PC) has a poor prognosis, with a 5-year survival of 3-4%. This is mainly due to late diagnosis because of diffuse symptoms, where 80-85% of the patients are inoperable. Consequently, early diagnosis would be of significant benefit, resulting in a potential 5-year survival of 30-40%. However, new technologies must be carefully evaluated concerning effectiveness and healthcare costs. We have developed a framework for modelling cost and health effects from early detection of PC, which for the first time allowed us to analyse its cost-effectiveness. A probabilistic cohort model for estimating costs and quality adjusted life-years (QALY) arising from screening for PC, compared to a "wait-and-see"-approach, was designed. The test accuracy, Swedish survival and costs by tumour stage, expected life gain from early detection and pre-test probabilities in risk-groups, were retrieved from previous investigations. In a cohort of newly diagnosed diabetic patient (incidence 0.71%) the incremental cost per QALY gained (ICER) was €13,500, which is considered cost-effective in Europe. Results were mainly sensitive to the incidence with the ICER ranging from €315 to €204,000 (familial PC 35% and general population 0.046%, respectively). This is the first study focusing on clinical implementation of advanced testing and what is required for novel technologies in cancer care to be cost-effective. The model clearly demonstrated the potential of multiplexed proteomic-testing of PC and also identified the requirements for test accuracy. Consequently, it can serve as a model for assessing the possibilities to introduce advanced test platforms also for other cancer indications. © 2013 Wiley Periodicals, Inc. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3804829
- author
- Ghatnekar, Ola ; Andersson, Roland LU ; Greiff Svensson, Marianne LU ; Persson, Ulf LU ; Ringdahl, Ulrika LU ; Zeilon, Paula LU and Borrebaeck, Carl LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- in
- International Journal of Cancer
- volume
- 133
- issue
- 10
- pages
- 2392 - 2397
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000324072300014
- pmid:23649606
- scopus:84883776306
- pmid:23649606
- ISSN
- 0020-7136
- DOI
- 10.1002/ijc.28256
- language
- English
- LU publication?
- yes
- id
- 62a2d247-6347-4f2d-9a2a-1a8719be4164 (old id 3804829)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23649606?dopt=Abstract
- date added to LUP
- 2016-04-01 10:56:36
- date last changed
- 2022-01-26 03:57:07
@article{62a2d247-6347-4f2d-9a2a-1a8719be4164,
abstract = {{Pancreatic cancer (PC) has a poor prognosis, with a 5-year survival of 3-4%. This is mainly due to late diagnosis because of diffuse symptoms, where 80-85% of the patients are inoperable. Consequently, early diagnosis would be of significant benefit, resulting in a potential 5-year survival of 30-40%. However, new technologies must be carefully evaluated concerning effectiveness and healthcare costs. We have developed a framework for modelling cost and health effects from early detection of PC, which for the first time allowed us to analyse its cost-effectiveness. A probabilistic cohort model for estimating costs and quality adjusted life-years (QALY) arising from screening for PC, compared to a "wait-and-see"-approach, was designed. The test accuracy, Swedish survival and costs by tumour stage, expected life gain from early detection and pre-test probabilities in risk-groups, were retrieved from previous investigations. In a cohort of newly diagnosed diabetic patient (incidence 0.71%) the incremental cost per QALY gained (ICER) was €13,500, which is considered cost-effective in Europe. Results were mainly sensitive to the incidence with the ICER ranging from €315 to €204,000 (familial PC 35% and general population 0.046%, respectively). This is the first study focusing on clinical implementation of advanced testing and what is required for novel technologies in cancer care to be cost-effective. The model clearly demonstrated the potential of multiplexed proteomic-testing of PC and also identified the requirements for test accuracy. Consequently, it can serve as a model for assessing the possibilities to introduce advanced test platforms also for other cancer indications. © 2013 Wiley Periodicals, Inc.}},
author = {{Ghatnekar, Ola and Andersson, Roland and Greiff Svensson, Marianne and Persson, Ulf and Ringdahl, Ulrika and Zeilon, Paula and Borrebaeck, Carl}},
issn = {{0020-7136}},
language = {{eng}},
number = {{10}},
pages = {{2392--2397}},
publisher = {{John Wiley & Sons Inc.}},
series = {{International Journal of Cancer}},
title = {{Modelling the benefits of early diagnosis of pancreatic cancer using a biomarker signature.}},
url = {{http://dx.doi.org/10.1002/ijc.28256}},
doi = {{10.1002/ijc.28256}},
volume = {{133}},
year = {{2013}},
}