Cost-Effectiveness of Genetic Testing for All Women Diagnosed with Breast Cancer in China

Sun, Li; Cui, Bin; Xia, Wei; Sadique, Zia; Yang, Li; Manchanda, Ranjit; Legood, Rosa

doi:10.3390/cancers14071839

Cited by 12 publications

(65 citation statements)

References 43 publications

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“…Three studies [ 23 , 26 , 27 ] targeted urban settings and one study [ 24 ] focused on rural areas. Only one of five identified articles analyzed the cost-effectiveness of unselected multigene testing strategies ( BRCA1 / BRCA2 / PALB2 testing, family history/clinical criteria-based BRCA testing) for all Chinese patients with breast cancer [ 25 ]. The main comparator in all studies was non-screening.…”

Section: Resultsmentioning

confidence: 99%

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Breast Cancer Screening Should Embrace Precision Medicine: Evidence by Reviewing Economic Evaluations in China

Jiang

Jiang²,

Ahumada-Canale³

et al. 2023

Adv Ther

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The cost-effectiveness of conventional population-based breast cancer screening strategies (e.g. mammography) has been found controversial, while evidence shows that genetic testing for early detection of pathogenic variants is cost-effective. We aimed to review the economic evaluations of breast cancer screening in China to provide an information summary for future research on this topic. We searched the literature to identify the economic evaluations that examined breast cancer screening and testing in China, supplemented by hand-searching the reference lists of the included studies. We finally included five studies satisfying our inclusion criteria. Four articles examined mammography while the rest investigated multigene testing. The existing breast cancer screening programmes were found to be cost-effective among urban Chinese women, but one study concluded that they might cause harm to women in rural areas. Contextual factors, such as data absence, urban–rural disparity, willingness-to-pay threshold, and model design, imposed barriers to cost-effectiveness analysis. Multigene testing was found to be cost-effective and has a promising population impact among all women with breast cancer in China. Future research should investigate the cost-effectiveness of screening and identifying breast cancer through precision medicine technologies, including genetic testing, genome sequencing, cascade testing, and the return of secondary findings.

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Section: Resultsmentioning

confidence: 99%

“…The main comparator in all studies was non-screening. Four studies incorporated additional comparators of varied screening intervals or different target populations [ 23 , 25 – 27 ]. The sample size varied between 26,244 and 1,252,074, wherein two studies used 100,000 hypothetical cohorts in their model [ 26 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

Breast Cancer Screening Should Embrace Precision Medicine: Evidence by Reviewing Economic Evaluations in China

Jiang

Jiang²,

Ahumada-Canale³

et al. 2023

Adv Ther

Self Cite

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“…Around 36.8% of colorectal cancer studies reported testing costs over US$ 2000, a stark contrast to 18.2% studies with similar pricing in HBOC. A few recent studies 17,20,21,25,45,46 saw a reduction in price of testing, yet for the most part costs remained highly variable across settings. 27,47 Assumptions on uptake of prophylactic risk reduction surgeries also influenced results and was the most predominant factor affecting cost-effectiveness in HBOC studies.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several additional studies on the cost-effectiveness of germline testing since the previous reviews. [16][17][18][19][20][21][22][23][24][25][26] Some of them assessed population-wide testing, 17,20 while others, evaluated the cost-utility of A c c e p t e d M a n u s c r i p t germline testing guided treatments in cancer patients with mutations. 26 Next-generation sequencing (NGS) has also become affordable.…”

Section: Introductionmentioning

confidence: 99%

A review of the cost-effectiveness of genetic testing for germline variants in familial cancer

Teppala

Hodgkinson

Hayes

et al. 2022

Journal of Medical Economics

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Author contributionsST performed the literature search, data abstraction and synthesis, quality assessment and prepared the first draft of the manuscript. HT, PS and SH contributed to the conceptual design of the study and towards revisions to the manuscript. BH reviewed the literature search, methodology, quality assessment and provided feedback for revisions. All the authors read and agreed to the final version of the article.

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“…Another notable issue concerns the price of BRCA mutation testing ( 84 ). Currently the price of BRCA mutation testing for a single sample in China is roughly 300 dollars ($), which is only paid by the patient side and not covered by the government side through basic medical insurance ( 85 ). Actually, the price of a single BRCA mutation testing is too high for the majority of ordinary Chinese.…”

Section: Problems Related To Panel Sequencingmentioning

confidence: 99%

Overview on population screening for carriers with germline BRCA mutation in China

Lei

Zhang²,

Zhang³

et al. 2022

Front. Oncol.

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Carriers with BRCA1/2 germline pathogenic variants are associated with a high risk of breast and ovarian cancers (also pancreatic and prostate cancers). While the spectrum on germline BRCA mutations among the Chinese population shows ethnic specificity, the identification of carriers with germline BRCA mutation before cancer onset is the most effective approach to protect them. This review focused on the current status of BRCA1/2 screening, the surveillance and prevention measures, and discussed the issues and potential impact of BRCA1/2 population screening in China. We conducted literature research on databases PubMed and Google Scholar, as well as Chinese databases CNKI and Wangfang Med Online database (up to 31 March 2022). Latest publications on germline BRCA1/2 prevalence, spectrum, genetic screening as well as carrier counseling, surveillance and prevention were captured where available. While overall 15,256 records were retrieved, 72 publications using germline BRCA1/2 testing were finally retained for further analyses. Germline BRCA1/2 mutations are common in Chinese patients with hereditary breast, ovarian, prostate and pancreatic cancers. Within previous studies, a unique BRCA mutation spectrum in China was revealed. Next-generation sequencing panel was considered as the most common method for BRCA1/2 screening. Regular surveillance and preventive surgeries were tailored to carriers with mutated-BRCA1/2. We recommend that all Chinese diagnosed with breast, ovarian, pancreatic or prostate cancers and also healthy family members, shall undergo BRCA1/2 gene test to provide risk assessment. Subsequently, timely preventive measures for mutation carriers are recommended after authentic genetic counseling.

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Cost-Effectiveness of Genetic Testing for All Women Diagnosed with Breast Cancer in China

Cited by 12 publications

References 43 publications

Breast Cancer Screening Should Embrace Precision Medicine: Evidence by Reviewing Economic Evaluations in China

Breast Cancer Screening Should Embrace Precision Medicine: Evidence by Reviewing Economic Evaluations in China

A review of the cost-effectiveness of genetic testing for germline variants in familial cancer

Overview on population screening for carriers with germline BRCA mutation in China

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