| Impact of screening test performance and cost on mortality reduction and cost-effectiveness of multimodal ovarian cancer screening. | |
| | |
MedLine Citation:
|
PMID: 22750949 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Ongoing ovarian cancer screening trials are investigating the efficacy of a two-step screening strategy using currently available blood and imaging tests (CA125 and transvaginal sonography [TVS]). Concurrently, efforts to develop new biomarkers and imaging tests seek to improve screening performance beyond its current limits. This study estimates the mortality reduction, years of life saved and cost-effectiveness achievable by annual multimodal screening using rising CA125 to select women for TVS, and predicts improvements achievable by replacing currently available screening tests with hypothetical counterparts with better performance characteristics. An existing stochastic micro-simulation model is refined and used to screen a virtual cohort of 1 million women from age 45 to 85. Each woman is assigned a detailed disease course and screening results timeline. The pre-clinical behavior of CA125 and TVS is simulated using empirical data derived from clinical trials. Simulations in which the disease incidence and performance characteristics of the screening tests are independently varied are performed in order to evaluate the impact of these factors on overall screening performance and costs. Our results demonstrate that when applied to women at average risk, annual screening using rising CA125 to select women for TVS achieves modest mortality reduction (~13%) and falls within currently accepted cost-effectiveness guidelines. Screening outcomes are relatively insensitive to second-line test performance and costs. Identification of a first line test that performs substantially better than CA125 and has similar costs is required in order for screening to reduce ovarian mortality by at least 25% and be reasonably cost-effective. |
| | |
Authors:
|
Charles W Drescher; Sarah H Hawley; Jason D Thorpe; Simone Marticke; Martin W McIntosh; Sanjiv Sam Gambhir; Nicole Urban |
Related Documents
:
|
22783689 - Asymptomatic bacteriuria in pregnancy: evaluation of reagent strips in comparison to mi... 22065399 - Development and application of whole-sediment toxicity test using immobilized freshwate... 22444369 - Prediction of genetic growth curves in pigs. 12678239 - Comparison and validation of novel pyrogen tests based on the human fever reaction. 22230559 - Pre- and post-palatoplasty eustachian tube function in infants with cleft palate. 19782219 - Simple, rapid, and highly sensitive detection of diphosgene and triphosgene by spectrop... 8817949 - Evaluation of the wear of the pivot bearing in the gyro c1e3 pump. 15629959 - Molecular diagnosis of pseudohypoparathyroidism type ib in a family with presumed parox... 16504469 - Validation of the voice handicap index using rasch analysis. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-7-2 |
Journal Detail:
|
Title: Cancer prevention research (Philadelphia, Pa.) Volume: - ISSN: 1940-6215 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
|
Created Date: 2012-7-3 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101479409 Medline TA: Cancer Prev Res (Phila) Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
1Public Health Sciences Division, Fred Hutchinson Cancer Res. Ctr. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A comparison of the physicochemical properties and a sensory test of Acyclovir creams.
Next Document: Worldwide regulatory guidance values for surface soil exposure to carcinogenic or mutagenic polycycl...