Population or family history based BRCA gene tests of breast cancer? A systematic review of economic evaluations
Abstract Background Nearly 56% of at-risk carriers are not identified and missed as a result of the current family-history (FH) screening for genetic testing. The present study aims to review the economic evaluation studies on BRCA genetic testing strategies for screening and early detection of brea...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Hereditary Cancer in Clinical Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13053-021-00191-0 |
| _version_ | 1818601129969188864 |
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| author | Zahra Meshkani Ali Aboutorabi Najmeh Moradi Mostafa Langarizadeh Ali Ghanbari Motlagh |
| author_facet | Zahra Meshkani Ali Aboutorabi Najmeh Moradi Mostafa Langarizadeh Ali Ghanbari Motlagh |
| author_sort | Zahra Meshkani |
| collection | DOAJ |
| description | Abstract Background Nearly 56% of at-risk carriers are not identified and missed as a result of the current family-history (FH) screening for genetic testing. The present study aims to review the economic evaluation studies on BRCA genetic testing strategies for screening and early detection of breast cancer. Methods This systematic literature review is conducted within the Cochrane Library, PubMed, Scopus, Web of Science, ProQuest, and EMBASE databases. In this paper, the relevant published economic evaluation studies are identified by following the standard Cochrane Collaboration methods and adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement reporting some recommendations for articles up to March 2020. Thereafter, the inclusion and exclusion criteria are applied to screen the articles. Disagreements are resolved through a consensus meeting. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist is used in the evaluation of quality. Finally, a narrative synthesis is performed. To compare the different levels of incremental cost-effectiveness ratio (ICER), the net present value is calculated based on a discount rate of 3% in 2019. Results Among 788 initially retrieved citations, 12 studies were included. More than 60% of the studies were originated from high-income countries and were published after 2016. It is noteworthy that most of the studies evaluated the payer perspective. Moreover, the robustness of the results were analyzed through one-way and probabilistic sensitivity analyses in nearly 66% of these studies. Nearly, 25% of the studies are focused and defined population-based and family history BRCA tests as comparators; afterwards, the cost-effectiveness of the former was confirmed. The highest and lowest absolute values for the ICERs were $65,661 and $9 per quality adjusted life years, respectively. All studies met over 70% of the CHEERs criteria checklist, which was considered as 93% of high quality on average as well. Conclusions The genetic BRCA tests for the general population as well as unselected breast cancer patients were cost-effective in high and upper-middle income countries and those with prevalence of gene mutation while population-based genetic tests for low-middle income countries are depended on the price of the tests. |
| first_indexed | 2024-12-16T12:46:29Z |
| format | Article |
| id | doaj.art-64597b7879474a9bbef5e9f1bf989c33 |
| institution | Directory Open Access Journal |
| issn | 1897-4287 |
| language | English |
| last_indexed | 2024-12-16T12:46:29Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Hereditary Cancer in Clinical Practice |
| spelling | doaj.art-64597b7879474a9bbef5e9f1bf989c332022-12-21T22:31:17ZengBMCHereditary Cancer in Clinical Practice1897-42872021-08-0119111510.1186/s13053-021-00191-0Population or family history based BRCA gene tests of breast cancer? A systematic review of economic evaluationsZahra Meshkani0Ali Aboutorabi1Najmeh Moradi2Mostafa Langarizadeh3Ali Ghanbari Motlagh4Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical SciencesHealth Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical SciencesHealth Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical SciencesDepartment of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical SciencesClinical Oncology, Shahid Beheshti Medical UniversityAbstract Background Nearly 56% of at-risk carriers are not identified and missed as a result of the current family-history (FH) screening for genetic testing. The present study aims to review the economic evaluation studies on BRCA genetic testing strategies for screening and early detection of breast cancer. Methods This systematic literature review is conducted within the Cochrane Library, PubMed, Scopus, Web of Science, ProQuest, and EMBASE databases. In this paper, the relevant published economic evaluation studies are identified by following the standard Cochrane Collaboration methods and adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement reporting some recommendations for articles up to March 2020. Thereafter, the inclusion and exclusion criteria are applied to screen the articles. Disagreements are resolved through a consensus meeting. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist is used in the evaluation of quality. Finally, a narrative synthesis is performed. To compare the different levels of incremental cost-effectiveness ratio (ICER), the net present value is calculated based on a discount rate of 3% in 2019. Results Among 788 initially retrieved citations, 12 studies were included. More than 60% of the studies were originated from high-income countries and were published after 2016. It is noteworthy that most of the studies evaluated the payer perspective. Moreover, the robustness of the results were analyzed through one-way and probabilistic sensitivity analyses in nearly 66% of these studies. Nearly, 25% of the studies are focused and defined population-based and family history BRCA tests as comparators; afterwards, the cost-effectiveness of the former was confirmed. The highest and lowest absolute values for the ICERs were $65,661 and $9 per quality adjusted life years, respectively. All studies met over 70% of the CHEERs criteria checklist, which was considered as 93% of high quality on average as well. Conclusions The genetic BRCA tests for the general population as well as unselected breast cancer patients were cost-effective in high and upper-middle income countries and those with prevalence of gene mutation while population-based genetic tests for low-middle income countries are depended on the price of the tests.https://doi.org/10.1186/s13053-021-00191-0Economic evaluationGenetic testBRCABreast cancer |
| spellingShingle | Zahra Meshkani Ali Aboutorabi Najmeh Moradi Mostafa Langarizadeh Ali Ghanbari Motlagh Population or family history based BRCA gene tests of breast cancer? A systematic review of economic evaluations Hereditary Cancer in Clinical Practice Economic evaluation Genetic test BRCA Breast cancer |
| title | Population or family history based BRCA gene tests of breast cancer? A systematic review of economic evaluations |
| title_full | Population or family history based BRCA gene tests of breast cancer? A systematic review of economic evaluations |
| title_fullStr | Population or family history based BRCA gene tests of breast cancer? A systematic review of economic evaluations |
| title_full_unstemmed | Population or family history based BRCA gene tests of breast cancer? A systematic review of economic evaluations |
| title_short | Population or family history based BRCA gene tests of breast cancer? A systematic review of economic evaluations |
| title_sort | population or family history based brca gene tests of breast cancer a systematic review of economic evaluations |
| topic | Economic evaluation Genetic test BRCA Breast cancer |
| url | https://doi.org/10.1186/s13053-021-00191-0 |
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