Testing of women with ovarian cancer based on history of cancer or ancestry likely cost-effective
THURSDAY, Oct. 22 (HealthDay News) -- Testing women with ovarian cancer for the BRCA mutation if they have a personal history of breast cancer, a family history of breast or ovarian cancer, or are of Ashkenazi Jewish ancestry, is a cost-effective strategy that may prevent cancers in first degree relatives (FDR), according to a study published online Oct. 19 in the Journal of Clinical Oncology.
Janice S. Kwon, M.D., of the University of British Columbia in Vancouver, Canada, and colleagues developed a Markov Monte Carlo model to evaluate the benefits of BRCA testing. The researchers compared four testing criteria, including no testing; testing if the patient has a personal history of breast cancer, or a family history of ovarian or breast cancers; the patient is of Ashkenazi Jewish ancestry; and testing only if the patient has invasive serous cancer or any invasive non-mucinous epithelial cancer.
The researchers found that BRCA testing could prevent future cancers in FDRs with an incremental cost-effectiveness ratio (ICER) of $32,018 per year of life (LY) gained in women with a personal or family history or of Ashkenazi Jewish ancestry. Testing in cases of serous or any non-mucinous epithelial ovarian cancer would prevent additional cancer in FDRs, but at prohibitively high ICERs ($128,465 and $148,363 per LY gained, respectively).
"BRCA testing of women with ovarian cancer based on personal/family history of cancer or Ashkenazi Jewish ancestry is a cost-effective strategy to prevent future breast and ovarian cancers among FDRs. More inclusive testing strategies prevent additional cancer cases but at significant cost," the authors conclude.
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