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Modelling the benefits of early diagnosis of pancreatic cancer using a biomarker signature.

Author:
  • Ola Ghatnekar
  • Roland Andersson
  • Marianne Greiff Svensson
  • Ulf Persson
  • Ulrika Ringdahl
  • Paula Zeilon
  • Carl Borrebaeck
Publishing year: 2013
Language: English
Pages: 2392-2397
Publication/Series: International Journal of Cancer
Volume: 133
Issue: 10
Document type: Journal article
Publisher: John Wiley & Sons

Abstract english

Pancreatic cancer (PC) has a poor prognosis, with a 5-year survival of 3-4%. This is mainly due to late diagnosis because of diffuse symptoms, where 80-85% of the patients are inoperable. Consequently, early diagnosis would be of significant benefit, resulting in a potential 5-year survival of 30-40%. However, new technologies must be carefully evaluated concerning effectiveness and healthcare costs. We have developed a framework for modelling cost and health effects from early detection of PC, which for the first time allowed us to analyse its cost-effectiveness. A probabilistic cohort model for estimating costs and quality adjusted life-years (QALY) arising from screening for PC, compared to a "wait-and-see"-approach, was designed. The test accuracy, Swedish survival and costs by tumour stage, expected life gain from early detection and pre-test probabilities in risk-groups, were retrieved from previous investigations. In a cohort of newly diagnosed diabetic patient (incidence 0.71%) the incremental cost per QALY gained (ICER) was €13,500, which is considered cost-effective in Europe. Results were mainly sensitive to the incidence with the ICER ranging from €315 to €204,000 (familial PC 35% and general population 0.046%, respectively). This is the first study focusing on clinical implementation of advanced testing and what is required for novel technologies in cancer care to be cost-effective. The model clearly demonstrated the potential of multiplexed proteomic-testing of PC and also identified the requirements for test accuracy. Consequently, it can serve as a model for assessing the possibilities to introduce advanced test platforms also for other cancer indications. © 2013 Wiley Periodicals, Inc.

Keywords

  • Cancer and Oncology

Other

Published
  • CREATE Health
  • ISSN: 0020-7136
Carl Borrebaeck
E-mail: carl.borrebaeck [at] immun.lth.se

Professor

Department of Immunotechnology

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Director

Create Health

+46 46 222 96 13

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