The cost-effectiveness of screening for ovarian cancer: results from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)
View/ Open
Author
Menon, Usha
McGuire, Alistair J
Raikou, Maria
Ryan, Andy
Davies, Susan K
Burnell, Matthew
Gentry-Maharaj, Aleksandra
Kalsi, Jatinderpal K
Singh, Naveena
Amso, Nazar N
Cruickshank, Derek
Dobbs, Stephen
Godfrey, Keith
Herod, Jonathan
Leeson, Simon
Mould, Tim
Murdoch, John
Oram, David
Scott, Ian
Seif, Mourad W
Williamson, Karin
Woolas, Robert
Fallowfield, Lesley
Campbell, Stuart
Parmar, Mahesh
Jacobs, Ian J
Note: Order does not necessarily reflect citation order of authors.
Published Version
https://doi.org/10.1038/bjc.2017.222Metadata
Show full item recordCitation
Menon, U., A. J. McGuire, M. Raikou, A. Ryan, S. K. Davies, M. Burnell, A. Gentry-Maharaj, et al. 2017. “The cost-effectiveness of screening for ovarian cancer: results from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).” British Journal of Cancer 117 (5): 619-627. doi:10.1038/bjc.2017.222. http://dx.doi.org/10.1038/bjc.2017.222.Abstract
Background: To assess the within-trial cost-effectiveness of an NHS ovarian cancer screening (OCS) programme using data from UKCTOCS and extrapolate results based on average life expectancy. Methods: Within-trial economic evaluation of no screening (C) vs either (1) an annual OCS programme using transvaginal ultrasound (USS) or (2) an annual ovarian cancer multimodal screening programme with serum CA125 interpreted using a risk algorithm (ROCA) and transvaginal ultrasound as a second-line test (MMS), plus comparison of lifetime extrapolation of the no screening arm and the MMS programme using both a predictive and a Markov model. Results: Using a CA125–ROCA cost of £20, the within-trial results show USS to be strictly dominated by MMS, with the MMS vs C comparison returning an incremental cost-effectiveness ratio (ICER) of £91 452 per life year gained (LYG). If the CA125–ROCA unit cost is reduced to £15, the ICER becomes £77 818 per LYG. Predictive extrapolation over the expected lifetime of the UKCTOCS women returns an ICER of £30 033 per LYG, while Markov modelling produces an ICER of £46 922 per QALY. Conclusion: Analysis suggests that, after accounting for the lead time required to establish full mortality benefits, a national OCS programme based on the MMS strategy quickly approaches the current NICE thresholds for cost-effectiveness when extrapolated out to lifetime as compared with the within-trial ICER estimates. Whether MMS could be recommended on economic grounds would depend on the confirmation and size of the mortality benefit at the end of an ongoing follow-up of the UKCTOCS cohort.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572177/pdf/Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAACitable link to this page
http://nrs.harvard.edu/urn-3:HUL.InstRepos:34375194
Collections
- HMS Scholarly Articles [17918]
Contact administrator regarding this item (to report mistakes or request changes)