caa a22 4500 445330546 CHVBK 20180317142735.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s10689-010-9397-7 doi (NATIONALLICENCE)springer-10.1007/s10689-010-9397-7 An analysis of the efficacy of serial screening for familial nasopharyngeal carcinoma based on Markov chain models [Elektronische Daten] [Cheuk Choi, Michael Lee, Wai Ng, Lai Law, Tsz Yau, Anne Lee] Treatment of nasopharyngeal carcinoma (NPC) can be improved by early detection of the disease as treatment outcome worsens with disease's progression. This can be achieved with a mass screening program using Epstein Barr virus (EBV) serology and nasopharyngoscopy. The efficacy of any screening strategy should be evaluated before putting it into practice. Such evaluation is ideally performed with simulation as time and cost often preclude the evaluation by randomized trial. This study simulated and compared the outcomes of 4 screening strategies over a period of 12years: (A) Annual screening, (B) biennial screening, (C) triennial screening, and (D) triennial screening for participants tested EBV negative and annual screening once the participants are tested EBV positive. Progression of the disease was divided into 4 phases and calculated by applying Markov chain model. Parameters of the transition matrix and probabilities were estimated using data from previous screening results of 1,072 family members of NPC patients. The early detection rates with strategies A, B, C and D are 88, 79, 71 and 87% respectively. The 5-year overall survival with screening is 10-12% higher than that without and is the highest with strategies A and D. Strategy D, however, requires only 64% screening tests compared with strategy A and has almost identical resultant disease stage distribution to strategy A. We concluded that strategy D offered the highest efficacy for NPC screening of family members of NPC patients among the four strategies studied. Springer Science+Business Media B.V., 2010 Nasopharyngeal carcinoma nationallicence Familial risk nationallicence Screening nationallicence Markov chain model nationallicence Choi Cheuk Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut Lee Michael Department of Medical Physics, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong aut Ng Wai Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut Law Lai Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut Yau Tsz Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut Lee Anne Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut Familial Cancer Springer Netherlands 10/1(2011-03-01), 133-139 1389-9600 10:1<133 2011 10 10689 https://doi.org/10.1007/s10689-010-9397-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10689-010-9397-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Choi Cheuk Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut NATIONALLICENCE 700 1- Lee Michael Department of Medical Physics, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong aut NATIONALLICENCE 700 1- Ng Wai Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut NATIONALLICENCE 700 1- Law Lai Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut NATIONALLICENCE 700 1- Yau Tsz Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut NATIONALLICENCE 700 1- Lee Anne Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong aut NATIONALLICENCE 773 0- Familial Cancer Springer Netherlands 10/1(2011-03-01), 133-139 1389-9600 10:1<133 2011 10 10689 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer