caa a22 4500 445330902 CHVBK 20180317142737.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s10689-011-9444-z doi (NATIONALLICENCE)springer-10.1007/s10689-011-9444-z A cost-effectiveness analysis of prophylactic surgery versus gynecologic surveillance for women from hereditary non-polyposis colorectal cancer (HNPCC) Families [Elektronische Daten] [Kathleen Yang, Aaron Caughey, Sarah Little, Michael Cheung, Lee-May Chen] Women at risk for Lynch Syndrome/HNPCC have an increased lifetime risk of endometrial and ovarian cancer. This study investigates the cost-effectiveness of prophylactic surgery versus surveillance in women with Lynch Syndrome. A decision analytic model was designed incorporating key clinical decisions and existing probabilities, costs, and outcomes from the literature. Clinical forum where risk-reducing surgery and surveillance were considered. A theoretical population of women with Lynch Syndrome at age 30 was used for the analysis. A decision analytic model was designed comparing the health outcomes of prophylactic hysterectomy with bilateral salpingo-oophorectomy at age 30 versus annual gynecologic screening versus annual gynecologic exam. The literature was searched for probabilities of different health outcomes, results of screening modalities, and costs of cancer diagnosis and treatment. Cost-effectiveness expressed in dollars per discounted life-years. Risk-reducing surgery is the least expensive option, costing $23,422 per patient for 25.71 quality-adjusted life-years (QALYs). Annual screening costs $68,392 for 25.17 QALYs; and annual examination without screening costs $100,484 for 24.60 QALYs. Further, because risk-reducing surgery leads to both the lowest costs and the highest number of QALYs, it is a dominant strategy. Risk-reducing surgery is the most cost-effective option from a societal healthcare cost perspective. Springer Science+Business Media B.V., 2011 Decision analysis nationallicence Lynch Syndrome nationallicence Hereditary non-polyposis colorectal cancer nationallicence Cost-effectiveness analysis nationallicence Quality of life nationallicence Risk-reducing surgery nationallicence Yang Kathleen Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, 1600 Divisadero St. 4th Floor, 94115-1702, San Francisco, CA, USA aut Caughey Aaron Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA aut Little Sarah Department of Obstetrics, Gynecology, and Reproductive Sciences, Brigham and Women's Hospital, Boston, MA, USA aut Cheung Michael Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA aut Chen Lee-May Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, 1600 Divisadero St. 4th Floor, 94115-1702, San Francisco, CA, USA aut Familial Cancer Springer Netherlands 10/3(2011-09-01), 535-543 1389-9600 10:3<535 2011 10 10689 https://doi.org/10.1007/s10689-011-9444-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10689-011-9444-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yang Kathleen Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, 1600 Divisadero St. 4th Floor, 94115-1702, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Caughey Aaron Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA aut NATIONALLICENCE 700 1- Little Sarah Department of Obstetrics, Gynecology, and Reproductive Sciences, Brigham and Women's Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Cheung Michael Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA aut NATIONALLICENCE 700 1- Chen Lee-May Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, 1600 Divisadero St. 4th Floor, 94115-1702, San Francisco, CA, USA aut NATIONALLICENCE 773 0- Familial Cancer Springer Netherlands 10/3(2011-09-01), 535-543 1389-9600 10:3<535 2011 10 10689 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer