Chemoprevention of colorectal cancer by aspirin: A cost-effectiveness analysis

Suleiman, Saud; Rex, Douglas K.; Sonnenberg, Amnon

doi:10.1053/gast.2002.29689

Cited by 73 publications

(47 citation statements)

References 40 publications

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“…Five of the six included economic evaluations compared chemoprevention with screening as well as with no prevention (see Table 29). [216][217][218][219][220] These five studies used a health economic model with annual cycles and reported outcomes in terms of the incremental or marginal cost per life-year (LY) saved from a third-party payer (Medicare®) perspective. None of these five studies assessed the impact of treatment or the disease on HRQoL.…”

Section: Included Economic Evaluationsmentioning

confidence: 99%

“…217 The time horizon, that is, the period over which costs and health outcomes differ between decision options, was inconsistent between the studies, ranging from 10 years to individuals' remaining lifetimes. Two of the economic evaluation studies did not incorporate a disease natural history component; 219,221 where a natural history component was included, the definition of disease states and transitions between them were inconsistent.…”

Section: Included Economic Evaluationsmentioning

confidence: 99%

“…The cost of aspirin was based on the costs used in Suleiman et al 219 and Ladabaum et al, 216 both described above. The cost of colonoscopy and polypectomy, complications of colonoscopy and aspirin, initial side effects of aspirin and CRC resection were based on Medicare reimbursement rates.…”

Section: Dupont Et Almentioning

confidence: 99%

See 2 more Smart Citations

Chemoprevention of colorectal cancer: systematic review and economic evaluation

Cooper

Squires²,

Carroll³

et al. 2010

Health Technol Assess

184

182

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of project...

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Section: Included Economic Evaluationsmentioning

confidence: 99%

Section: Included Economic Evaluationsmentioning

confidence: 99%

See 1 more Smart Citation

Chemoprevention of colorectal cancer: systematic review and economic evaluation

Cooper

Squires²,

Carroll³

et al. 2010

Health Technol Assess

184

182

View full text Add to dashboard Cite

show abstract

“…Their use in primary and secondary prevention of colorectal neoplasia is not currently recommended as not all individuals derive benefit and some experience side effects (5,6). Identification of genetic factors predictive of aspirin response could allow targeted prevention to individuals predisposed to gain differential benefit, thus altering the balance between benefit and risk.…”

Section: Aspirin and Nonsteroidal Anti-inflammatory Drugs (Nsaid)mentioning

confidence: 99%

Ornithine Decarboxylase G316A Genotype Is Prognostic for Colorectal Adenoma Recurrence and Predicts Efficacy of Aspirin Chemoprevention

Muir¹,

Liu²,

Logan³

et al. 2008

Clinical Cancer Research

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Purpose:The chemopreventive activity of aspirin in colorectal neoplasia may be explained in part by its effect on polyamine metabolism.The ornithine decarboxylase (ODC) G316A polymorphism affects polyamine metabolism through altered expression of ODC. We investigated the influence of ODC G316A on the chemopreventive activity of aspirin in colorectal adenoma (CRA) recurrence. Experimental Design: We genotyped ODC G316A in 546 individuals in the United Kingdom Colorectal Adenoma Prevention trial of aspirin for CRA recurrence prevention and pooled our findings with data from two other randomized intervention trials. Results: The United Kingdom Colorectal Adenoma Prevention participants with homozygous ODC 316AA genotype were at reduced CRA recurrence risk [relative risk (RR), 0.43; 95% confidence interval (95% CI), 0.16-1.15], particularly if also exposed to aspirin (RR, 0.24; 95% CI, 0.03-1.71). In the pooled analysis of 2,207 individuals, those with homozygous ODC 316AA genotype were at significantly reduced CRA recurrence risk (RR, 0.68; 95% CI, 0.47-0.99). Following stratification by genotype and aspirin exposure, individuals with homozygous wild-type or heterozygous genotypes derived modest benefit from aspirin (RR, 0.85; 95% CI, 0.72-1.01), whereas in those with both ODC 316AA genotype and aspirin exposure recurrence risk was halved (RR, 0.52; 95% CI, 0.29-0.91). Conclusion:The ODC G316A genotype is prognostic for CRA recurrence and predictive of an enhanced response to aspirin in preventing recurrence. This variant has the potential to be a clinically useful genetic marker to identify individuals likely to derive the greatest benefit from aspirin chemoprevention.

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“…However, the modest neoplasia reduction rate (30 -50%; refs. 5 -7) and risk of toxicity (e.g., increased risk of gastrointestinal bleeding and hemorrhagic strokes) have lead most decision analyses to conclude that aspirin is not cost-effective for colorectal cancer prevention in the general population (8,9). Additionally, whereas statins may be better tolerated and offers similar risk reductions to aspirin, it is estimated that to prevent a single colorectal cancer, one would need to treat as many as 4,814 subjects (10).…”

Section: Introductionmentioning

confidence: 99%

Chemoprevention of colon carcinogenesis by polyethylene glycol: suppression of epithelial proliferation via modulation of SNAIL/β-catenin signaling

Roy

Kunte

Koetsier

et al. 2006

Molecular Cancer Therapeutics

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Polyethylene glycol (PEG) is one of the most potent chemopreventive agents against colorectal cancer; however, the mechanisms remain largely unexplored. In this study, we assessed the ability of PEG to target cyclin D1 -B-catenin -mediated hyperproliferation in the azoxymethane-treated rat model and the human colorectal cancer cell line, HT-29. Azoxymethane-treated rats were randomized to AIN-76A diet alone or supplemented with 5% PEG-8000. After 30 weeks, animals were euthanized and biopsies of aberrant crypt foci and uninvolved crypts were subjected to immunohistochemical and immunoblot analyses. PEG markedly suppressed both early and late markers of azoxymethane-induced colon carcinogenesis (fractal dimension by 80%, aberrant crypt foci by 64%, and tumors by 74%). In both azoxymethane-treated rats and HT-29 cells treated with 5% PEG-3350 for 24 hours, PEG decreased proliferation (45% and 52%, respectively) and cyclin D1 (78% and 56%, respectively). Because B-catenin is the major regulator of cyclin D1 in colorectal cancer, we used the T-cell factor (Tcf) -TOPFLASH reporter assay to show that PEG markedly inhibited B-catenin transcriptional activity. PEG did not alter total B-catenin expression but rather its nuclear localization, leading us to assess E-cadherin expression (a major determinant of B-catenin subcellular localization), which was increased by 73% and 71% in the azoxymethane-rat and HT-29 cells, respectively. We therefore investigated the effect of PEG treatment on levels of the negative regulator of E-cadherin, SNAIL, and observed a 50% and 75% decrease, respectively. In conclusion, we show, for the first time, a molecular mechanism through which PEG imparts its antiproliferative and hence profound chemopreventive effect.

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Chemoprevention of colorectal cancer by aspirin: A cost-effectiveness analysis

Cited by 73 publications

References 40 publications

Chemoprevention of colorectal cancer: systematic review and economic evaluation

Chemoprevention of colorectal cancer: systematic review and economic evaluation

Ornithine Decarboxylase G316A Genotype Is Prognostic for Colorectal Adenoma Recurrence and Predicts Efficacy of Aspirin Chemoprevention

Chemoprevention of colon carcinogenesis by polyethylene glycol: suppression of epithelial proliferation via modulation of SNAIL/β-catenin signaling

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