PURPOSE: Women with endometrial cancer as a result of Lynch syndrome may not be identified as such by Amsterdam II criteria. We estimated the costs and benefits of different testing criteria to identify Lynch syndrome in women with endometrial cancer. METHODS: We developed a Markov Monte Carlo simulation model to compare six criteria for Lynch syndrome testing for women with endometrial cancer: Amsterdam II criteria; age younger than 50 years with at least one first-degree relative having a Lynch-associated cancer at any age (FDR); immunohistochemistry (IHC) triage if age younger than 50 years; IHC triage if age younger than 60 years; IHC triage at any age if 1 FDR; and IHC triage of all endometrial cancers. Net health benefit was life expectancy, and primary outcome was the incremental cost-effectiveness ratio (ICER). The model estimated the number of new colorectal cancers associated with each strategy. RESULTS: IHC triage of women with endometrial cancer having at least 1 FDR yielded a favorable ICER of $9,126 per year of life gained. This strategy would subject fewer cases to IHC but identify more mutation carriers than age thresholds of 50 or 60 years. IHC triage of all endometrial cancers could identify the most mutation carriers and prevent the most colorectal cancers but at considerable cost ($648,494 per year of life gained). CONCLUSION: IHC triage of women with endometrial cancer at any age having at least 1 FDR with a Lynch-associated cancer is a cost-effective strategy for detecting Lynch syndrome.
PURPOSE:Women with endometrial cancer as a result of Lynch syndrome may not be identified as such by Amsterdam II criteria. We estimated the costs and benefits of different testing criteria to identify Lynch syndrome in women with endometrial cancer. METHODS: We developed a Markov Monte Carlo simulation model to compare six criteria for Lynch syndrome testing for women with endometrial cancer: Amsterdam II criteria; age younger than 50 years with at least one first-degree relative having a Lynch-associated cancer at any age (FDR); immunohistochemistry (IHC) triage if age younger than 50 years; IHC triage if age younger than 60 years; IHC triage at any age if 1 FDR; and IHC triage of all endometrial cancers. Net health benefit was life expectancy, and primary outcome was the incremental cost-effectiveness ratio (ICER). The model estimated the number of new colorectal cancers associated with each strategy. RESULTS: IHC triage of women with endometrial cancer having at least 1 FDR yielded a favorable ICER of $9,126 per year of life gained. This strategy would subject fewer cases to IHC but identify more mutation carriers than age thresholds of 50 or 60 years. IHC triage of all endometrial cancers could identify the most mutation carriers and prevent the most colorectal cancers but at considerable cost ($648,494 per year of life gained). CONCLUSION: IHC triage of women with endometrial cancer at any age having at least 1 FDR with a Lynch-associated cancer is a cost-effective strategy for detecting Lynch syndrome.
Authors: L R Lipton; V Johnson; C Cummings; S Fisher; P Risby; A T Eftekhar Sadat; T Cranston; L Izatt; P Sasieni; S V Hodgson; H J W Thomas; I P M Tomlinson Journal: J Clin Oncol Date: 2004-12-15 Impact factor: 44.544
Authors: Heather Hampel; Julie A Stephens; Eero Pukkala; Risto Sankila; Lauri A Aaltonen; Jukka-Pekka Mecklin; Albert de la Chapelle Journal: Gastroenterology Date: 2005-08 Impact factor: 22.682
Authors: Heather Hampel; Wendy Frankel; Jenny Panescu; Janet Lockman; Kaisa Sotamaa; Daniel Fix; Ilene Comeras; Jennifer La Jeunesse; Hidewaki Nakagawa; Judith A Westman; Thomas W Prior; Mark Clendenning; Pamela Penzone; Janet Lombardi; Patti Dunn; David E Cohn; Larry Copeland; Lynne Eaton; Jeffrey Fowler; George Lewandowski; Luis Vaccarello; Jeffrey Bell; Gary Reid; Albert de la Chapelle Journal: Cancer Res Date: 2006-08-01 Impact factor: 12.701
Authors: J M Cunningham; C Y Kim; E R Christensen; D J Tester; Y Parc; L J Burgart; K C Halling; S K McDonnell; D J Schaid; C Walsh Vockley; V Kubly; H Nelson; V V Michels; S N Thibodeau Journal: Am J Hum Genet Date: 2001-08-24 Impact factor: 11.025
Authors: Karen H Lu; Mai Dinh; Wendy Kohlmann; Patrice Watson; Jane Green; Sapna Syngal; Prathap Bandipalliam; Lee-May Chen; Brian Allen; Peggy Conrad; Jonathan Terdiman; Charlotte Sun; Molly Daniels; Thomas Burke; David M Gershenson; Henry Lynch; Patrick Lynch; Russell R Broaddus Journal: Obstet Gynecol Date: 2005-03 Impact factor: 7.661
Authors: Kathleen Lang; Lisa M Lines; David W Lee; Jonathan R Korn; Craig C Earle; Joseph Menzin Journal: Clin Gastroenterol Hepatol Date: 2008-09-04 Impact factor: 11.382
Authors: Karuna Garg; Douglas A Levine; Narciso Olvera; Fanny Dao; Maria Bisogna; Angeles Alvarez Secord; Andrew Berchuck; Ethan Cerami; Nikolaus Schultz; Robert A Soslow Journal: Am J Surg Pathol Date: 2013-01 Impact factor: 6.394
Authors: Amanda S Bruegl; Bojana Djordjevic; Diana L Urbauer; Shannon N Westin; Pamela T Soliman; Karen H Lu; Rajyalakshmi Luthra; Russell R Broaddus Journal: Curr Pharm Des Date: 2014 Impact factor: 3.116
Authors: Amanda S Bruegl; Bojana Djordjevic; Brittany Batte; Molly Daniels; Bryan Fellman; Diana Urbauer; Rajyalakshmi Luthra; Charlotte Sun; Karen H Lu; Russell R Broaddus Journal: Cancer Prev Res (Phila) Date: 2014-04-25
Authors: Molly S Daniels; Diana L Urbauer; Azadeh Zangeneh; Brittany A L Batte; Katherine M Dempsey; Karen H Lu Journal: Gynecol Oncol Date: 2013-10-17 Impact factor: 5.482
Authors: Maria I Carlo; Vignesh Ravichandran; Preethi Srinavasan; Chaitanya Bandlamudi; Yelena Kemel; Ozge Ceyhan-Birsoy; Semanti Mukherjee; Diana Mandelker; Joshua Chaim; Andrea Knezevic; Satshil Rana; Zarina Fnu; Kelsey Breen; Angela G Arnold; Aliya Khurram; Kaitlyn Tkachuk; Catharine K Cipolla; Ashley Regazzi; A Ari Hakimi; Hikmat Al-Ahmadie; Guido Dalbagni; Karen A Cadoo; Michael F Walsh; Min-Yuen Teo; Samuel A Funt; Jonathan A Coleman; Bernard H Bochner; Gopa Iyer; David B Solit; Zsofia K Stadler; Liying Zhang; Jonathan E Rosenberg; Barry S Taylor; Mark E Robson; Michael F Berger; Joseph Vijai; Dean F Bajorin; Kenneth Offit Journal: J Clin Oncol Date: 2019-12-03 Impact factor: 44.544
Authors: Rowena C Mercado; Heather Hampel; Fay Kastrinos; Ewout Steyerberg; Judith Balmana; Elena Stoffel; David E Cohn; Floor J Backes; John L Hopper; Mark A Jenkins; Noralane M Lindor; Graham Casey; Robert Haile; Subha Madhavan; Albert de la Chapelle; Sapna Syngal Journal: Genet Med Date: 2012-03-08 Impact factor: 8.822