Breast cancer surveillance ? a cost-effective strategy

1993 ◽  
Vol 25 (2) ◽  
pp. 107-111 ◽  
Author(s):  
David V. Schapira
Keyword(s):  
Breast Cancer ◽  
Cost Effective ◽  
Cancer Surveillance ◽  
Effective Strategy ◽  
Cost Effective Strategy

scholarly journals Detecting Germline PTEN Mutations Among At-Risk Patients With Cancer: An Age- and Sex-Specific Cost-Effectiveness Analysis

2015 ◽  
Vol 33 (23) ◽  
pp. 2537-2544 ◽  
Author(s):  
Joanne Ngeow ◽  
Chang Liu ◽  
Ke Zhou ◽  
Kevin D. Frick ◽  
David B. Matchar ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cleveland Clinic ◽  
Cost Effective ◽  
Cancer Surveillance ◽  
Sensitivity Analyses ◽  
Base Case ◽  
Effective Strategy ◽  
Female Patients ◽  
Cost Effective Strategy ◽  
The Cost

Purpose Cowden syndrome (CS) is an autosomal dominant disorder characterized by benign and malignant tumors. One-quarter of patients who are diagnosed with CS have pathogenic germline PTEN mutations, which increase the risk of the development of breast, thyroid, uterine, renal, and other cancers. PTEN testing and regular, intensive cancer surveillance allow for early detection and treatment of these cancers for mutation-positive patients and their relatives. Individual CS-related features, however, occur commonly in the general population, making it challenging for clinicians to identify CS-like patients to offer PTEN testing. Patients and Methods We calculated the cost per mutation detected and analyzed the cost-effectiveness of performing selected PTEN testing among CS-like patients using a semi-quantitative score (the PTEN Cleveland Clinic [CC] score) compared with existing diagnostic criteria. In our model, first-degree relatives of the patients with detected PTEN mutations are offered PTEN testing. All individuals with detected PTEN mutations are offered cancer surveillance. Results CC score at a threshold of 15 (CC15) costs from $3,720 to $4,573 to detect one PTEN mutation, which is the most inexpensive among the different strategies. At base-case, CC10 is the most cost-effective strategy for female patients who are younger than 40 years, and CC15 is the most cost-effective strategy for female patients who are between 40 and 60 years of age and male patients of all ages. In sensitivity analyses, CC15 is robustly the most cost-effective strategy for probands who are younger than 60 years. Conclusion Use of the CC score as a clinical risk calculator is a cost-effective prescreening method to identify CS-like patients for PTEN germline testing.

scholarly journals Cost–utility of adjuvant zoledronic acid in patients with breast cancer and low estrogen levels

2015 ◽  
Vol 22 (4) ◽  
pp. 246
Author(s):  
N.W.D. Lamond ◽  
C. Skedgel ◽  
D. Rayson ◽  
T. Younis
Keyword(s):  
Breast Cancer ◽  
Zoledronic Acid ◽  
Disease Free Survival ◽  
Cost Effective ◽  
Cost Utility ◽  
Sensitivity Analyses ◽  
Effective Strategy ◽  
Natural Menopause ◽  
Cost Effective Strategy ◽  
Life Years

Background Adjuvant zoledronic acid (za) appears to improve disease-free survival (dfs) in women with earlystage breast cancer and low levels of estrogen (lle) because of induced or natural menopause. Characterizing the cost–utility (cu) of this therapy could help to determine its role in clinical practice.Methods Using the perspective of the Canadian health care system, we examined the cu of adjuvant endocrine therapy with or without za in women with early-stage endocrine-sensitive breast cancer and lle. A Markov model was used to compute the cumulative costs in Canadian dollars and the quality-adjusted life-years (qalys) gained from each adjuvant strategy, discounted at a rate of 5% annually. The model incorporated the dfs and fracture benefits of adjuvant za. Probabilistic and one-way sensitivity analyses were conducted to examine key model parameters.ResultsCompared with a no-za strategy, adjuvant za in the induced and natural menopause groups was associated with, respectively, $7,825 and $7,789 in incremental costs and 0.46 and 0.34 in qaly gains for cu ratios of $17,007 and $23,093 per qaly gained. In one-way sensitivity analyses, the results were most sensitive to changes in the za dfs benefit. Probabilistic sensitivity analysis suggested a 100% probability of adjuvant za being a cost-effective strategy at a threshold of $100,000 per qaly gained. ConclusionsBased on available data, adjuvant za appears to be a cost-effective strategy in women with endocrinesensitive breast cancer and lle, having cu ratios well below accepted thresholds.

A cost effective strategy to fabricate STA@PF@Cu2O hierarchical structure on wood surface: aimed at superhydrophobic modification

2021 ◽  
Vol 55 (2) ◽  
pp. 565-583
Author(s):  
Ke Zhan ◽  
Quanxiong Lu ◽  
Sengwei Xia ◽  
Congnan Guo ◽  
Sisi Zhao ◽  
...  
Keyword(s):  
Hierarchical Structure ◽  
Wood Surface ◽  
Cost Effective ◽  
Effective Strategy ◽  
Cost Effective Strategy

A cost effective strategy for managing GI bleeding secondary to peptic ulcer disease

1995 ◽  
Vol 108 (4) ◽  
pp. A18 ◽  
Author(s):  
I Hussain ◽  
WH Farrar ◽  
EJ Sofian ◽  
TF Bader ◽  
JD Strom ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Cost Effective ◽  
Effective Strategy ◽  
Gi Bleeding ◽  
Ulcer Disease ◽  
Cost Effective Strategy

scholarly journals Scaling-Up the Recognition of Indigenous and Community Land Rights: Opportunities, Costs and Climate Implications

2021 ◽  
Author(s):  
◽  
Keyword(s):  
Indigenous Peoples ◽  
Cost Effective ◽  
Land Rights ◽  
Scaling Up ◽  
Local Communities ◽  
Effective Strategy ◽  
Cost Effective Strategy ◽  
International Funding ◽  
Growing Body ◽  
Alternative Solutions

A growing body of evidence suggests that recognition of the collective tenure rights of Indigenous Peoples, local communities, and Afro-descendants is a powerful and cost-effective strategy for addressing the climate and biodiversity crises. In spite of this, international funding for rights recognition pales in comparison to donor mobilization around alternative solutions to these crises.

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