PURPOSE: The Food and Drug Administration recently approved the use of bladder markers such as BladderChek (NMP22; Matritech, Inc., Newton, MA) and UroVysion (Abbott Laboratories, Abbott Park, IL) for use in screening for bladder cancer. The purpose of this analysis was to assess the cost associated with implementing a widespread screening program using a noninvasive bladder tumor marker. METHODS: Data for the accuracy of NMP22 in detecting bladder cancer was gathered from a comprehensive literature review. A decision tree analysis was constructed to evaluate the total cost of screening a low and high-risk population for bladder cancer using NMP22. Sensitivity analyses were conducted to evaluate the effect of relaxing the various assumptions in the model. RESULTS: Application of the model to all men, regardless of the degree of risk, rendered a cost per cancer detected of $783,913, $269,028, and $139,305 for ages 50-59, 60-69, and 70-79 years, respectively. Screening only patients at high-risk for bladder cancer (annual incidence 6%) would yield a cost per cancer detected of $3,310. Incidence of cancer and marker specificity had the highest influence on cost per cancer detected. CONCLUSIONS: Application of NMP22 to the entire population would render an extremely high cost per cancer detected. However, application to an appropriate high-risk target population could achieve cost per cancer detected comparable to currently used screening programs for prostate, colon, and breast cancer. Further studies are needed to assess the accuracy of bladder tumor markers in detecting bladder cancer in a completely asymptomatic cohort.
PURPOSE: The Food and Drug Administration recently approved the use of bladder markers such as BladderChek (NMP22; Matritech, Inc., Newton, MA) and UroVysion (Abbott Laboratories, Abbott Park, IL) for use in screening for bladder cancer. The purpose of this analysis was to assess the cost associated with implementing a widespread screening program using a noninvasive bladder tumor marker. METHODS: Data for the accuracy of NMP22 in detecting bladder cancer was gathered from a comprehensive literature review. A decision tree analysis was constructed to evaluate the total cost of screening a low and high-risk population for bladder cancer using NMP22. Sensitivity analyses were conducted to evaluate the effect of relaxing the various assumptions in the model. RESULTS: Application of the model to all men, regardless of the degree of risk, rendered a cost per cancer detected of $783,913, $269,028, and $139,305 for ages 50-59, 60-69, and 70-79 years, respectively. Screening only patients at high-risk for bladder cancer (annual incidence 6%) would yield a cost per cancer detected of $3,310. Incidence of cancer and marker specificity had the highest influence on cost per cancer detected. CONCLUSIONS: Application of NMP22 to the entire population would render an extremely high cost per cancer detected. However, application to an appropriate high-risk target population could achieve cost per cancer detected comparable to currently used screening programs for prostate, colon, and breast cancer. Further studies are needed to assess the accuracy of bladder tumor markers in detecting bladder cancer in a completely asymptomatic cohort.
Authors: Wei Tang; Yi-Ping Fu; Jonine D Figueroa; Núria Malats; Montserrat Garcia-Closas; Nilanjan Chatterjee; Manolis Kogevinas; Dalsu Baris; Michael Thun; Jennifer L Hall; Immaculata De Vivo; Demetrius Albanes; Patricia Porter-Gill; Mark P Purdue; Laurie Burdett; Luyang Liu; Amy Hutchinson; Timothy Myers; Adonina Tardón; Consol Serra; Alfredo Carrato; Reina Garcia-Closas; Josep Lloreta; Alison Johnson; Molly Schwenn; Margaret R Karagas; Alan Schned; Amanda Black; Eric J Jacobs; W Ryan Diver; Susan M Gapstur; Jarmo Virtamo; David J Hunter; Joseph F Fraumeni; Stephen J Chanock; Debra T Silverman; Nathaniel Rothman; Ludmila Prokunina-Olsson Journal: Hum Mol Genet Date: 2012-01-06 Impact factor: 6.150
Authors: Jean V Joseph; Ralph Brasacchio; Chunkit Fung; Jay Reeder; Kevin Bylund; Deepak Sahasrabudhe; Shu Yuan Yeh; Ahmed Ghazi; Patrick Fultz; Deborah Rubens; Guan Wu; Eric Singer; Edward Schwarz; Supriya Mohile; James Mohler; Dan Theodorescu; Yi Fen Lee; Paul Okunieff; David McConkey; Hani Rashid; Chawnshang Chang; Yves Fradet; Khurshid Guru; Janet Kukreja; Gerald Sufrin; Yair Lotan; Howard Bailey; Katia Noyes; Seymour Schwartz; Kathy Rideout; Gennady Bratslavsky; Steven C Campbell; Ithaar Derweesh; Per-Anders Abrahamsson; Mark Soloway; Leonard Gomella; Dragan Golijanin; Robert Svatek; Thomas Frye; Seth Lerner; Ganesh Palapattu; George Wilding; Michael Droller; Donald Trump Journal: Bladder Cancer Date: 2018-10-03
Authors: Li-Mei Chen; Myron Chang; Yunfeng Dai; Karl X Chai; Lars Dyrskjøt; Marta Sanchez-Carbayo; Tibor Szarvas; Ellen C Zwarthoff; Vinata Lokeshwar; Carmen Jeronimo; Alexander S Parker; Shanti Ross; Michael Borre; Torben F Orntoft; Tobias Jaeger; Willemien Beukers; Luis E Lopez; Rui Henrique; Paul R Young; Virginia Urquidi; Steve Goodison; Charles J Rosser Journal: Cancer Epidemiol Biomarkers Prev Date: 2014-06-11 Impact factor: 4.254