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Modelling the benefits of early diagnosis of pancreatic cancer using a biomarker signature.

Ghatnekar, Ola; Andersson, Roland LU ; Greiff Svensson, Marianne LU ; Persson, Ulf LU ; Ringdahl, Ulrika LU ; Zeilon, Paula LU and Borrebaeck, Carl LU (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:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Cancer
volume
133
issue
10
pages
2392 - 2397
publisher
John Wiley & Sons
external identifiers
  • wos:000324072300014
  • pmid:23649606
  • scopus:84883776306
ISSN
0020-7136
DOI
10.1002/ijc.28256
project
CREATE Health
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
2013-06-06 15:35:55
date last changed
2019-02-20 02:57:01
@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},
  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},
  volume       = {133},
  year         = {2013},
}