NEW YORK (Reuters Health) - Genetic counseling and breast cancer screening for breast cancer patients’ relatives who are at high risk for the disease appears to be fairly cost-effective, Spanish researchers report.
Their analysis also suggests that women with cancers identified through the screening program were more likely to have node-negative disease than women whose cancers were diagnosed outside of the program, although the finding did not reach statistical significance.
Dr. Judith Balmana of the Universitat Autonoma de Barcelona and colleagues report on their familial breast cancer genetic counseling program’s cost-effectiveness in the November 20th issue of the International Journal of Cancer.
Their analysis included 143 families registered in the program’s database since the program began in 1995. Seventy-three percent of the families were considered high risk because they included at least three women with breast or ovarian cancer or a male with breast cancer. The remaining families were classified as moderate risk.
Relatives of women with breast cancer were divided into three screening groups: women at risk of hereditary breast cancer without a mutation in the proband; women with the BRCA1 or BRCA2 gene; and women without BRCA1 or BRCA2 from families with one of these mutations.
Women in the first two groups received genetic counseling and annual mammography and clinical breast exams from age 30 on, while the women in the third group did not undergo special screening.
The researchers estimate that 858 women received screening recommendations through the program.
Since the beginning of the program, 70 cases of breast cancer were diagnosed in the population, and 30% were identified through the screening program. Seventy-one percent of the cancers identified through screening were lymph-node-negative, while 49% of breast cancers diagnosed outside the program were (p = 0.1)
“Despite the limits of the sample size, this study suggests that there may be a tendency toward lowering the stage at diagnosis of breast cancers in the group who had followed a screening program with annual clinical breast examination and mammography compared with the group that did not perform any kind of screening,” the researchers note.
The researchers estimate that the program produced a 2.4-month increase in life expectancy, at a cost of 4,294 euros per year of life gained.
“In our view, the global benefit of the genetic counseling program may be increased with a more precise identification of the population likely to enter this program, improvement in the sensitivity of the laboratory techniques to identify mutations, and the development of new strategies for the early detection of these tumors,” the researchers conclude.
Source: Int J Cancer 2004;112:647-652. [ Google search on this article ]
MeSH Headings:Behavioral Sciences: Community Health Services: Cost-Benefit Analysis: Costs and Cost Analysis: Data Collection: Diagnosis: Diagnostic Services: Behavioral Disciplines and Activities: Economics: Health Care Economics and Organizations: Environment and Public Health: Epidemiologic Methods: Health Care Facilities, Manpower, and Services: Genetic Screening: Health: Health Occupations: Health Services: Health Services Administration: Health Surveys: Information Science: Mass Screening: Medicine: Investigative Techniques: Population Characteristics: Preventive Health Services: Preventive Medicine: Public Health: Quality of Health Care: Social Sciences: Specialties, Medical: Public Health Practice: Health Care Quality, Access, and Evaluation: Health Care Evaluation Mechanisms: Genes, BRCA1: Diagnostic Techniques and Procedures: Analytical, Diagnostic and Therapeutic Techniques and Equipment: Anthropology, Education, Sociology and Social Phenomena: Biological Sciences: Health Care: Information Science: Psychiatry and PsychologyCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
