Modelling the benefits of early diagnosis of pancreatic cancer using a biomarker signature
Open accessAbstract
Pancreatic cancer (PC) has a poor prognosis, with a 5-year survival of 3-4%. This is mainly due to late diagnosis because of diffuse symptoms, where 80-85% of the patients are inoperable. Consequently, early diagnosis would be of significant benefit, resulting in a potential 5-year survival of 30-40%. However, new technologies must be carefully evaluated concerning effectiveness and healthcare costs. We have developed a framework for modelling cost and health effects from early detection of PC, which for the first time allowed us to analyse its cost-effectiveness. A probabilistic cohort model for estimating costs and quality adjusted life-years (QALY) arising from screening for PC, compared to a "wait-and-see"-approach, was designed. The test accuracy, Swedish survival and costs by tumour stage, expected life gain from early detection and pretest probabilities in risk groups, were retrieved from previous investigations. In a cohort of newly diagnosed diabetic patient (incidence 0.71%) the incremental cost per QALY gained (ICER) was €13,500, which is considered cost-effective in Europe. Results were mainly sensitive to the incidence with the ICER ranging from €315 to €204,000 (familial PC 35% and general population 0.046%, respectively). This is the first study focusing on clinical implementation of advanced testing and what is required for novel technologies in cancer care to be cost-effective. The model clearly demonstrated the potential of multiplexed proteomic-testing of PC and also identified the requirements for test accuracy. Consequently, it can serve as a model for assessing the possibilities to introduce advanced test platforms also for other cancer indications.
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Ghatnekar and colleagues developed a framework for modelling cost and quality-adjusted life-years of serum biomarker-mediated early detection of pancreatic ductal adenocarcinoma in individuals with new-onset diabetes.
“Ghatnekar and colleagues74 developed a framework for modelling cost and quality-adjusted life-years of serum biomarker-mediated early detection of pancreatic ductal adenocarcinoma in individuals with new-onset diabetes.”
From Early detection of pancreatic cancer (2020) · cites this paper as [74]
That study, done within the Swedish health-care system, concluded that biomarker-mediated screening is highly desirable.
“This study, which was done within the Swedish health-care system, concluded that biomarker-mediated screening is highly desirable.”
From Early detection of pancreatic cancer (2020) · cites this paper as [74]
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Cites
Spencer, P. M., Cameron, J. L., & Lin, L. (2000) · Cited by 7,202 · see citing works
Hidalgo, M. (2010) · New England Journal of Medicine · doi:10.1056/nejmra0901557 · Cited by 2,570 · see citing works
Distant metastasis occurs late during the genetic evolution of pancreatic cancer
Yachida, S., Jones, S., Bozic, I., Antal, T., Leary, R., Fu, B., Kamiyama, M., Hruban, R. H., Eshleman, J. R., Nowak, M. A., et al. (2010) · Nature · doi:10.1038/nature09515 · Cited by 2,502 · see citing works
Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions
Fenwick, E. A. L., OʼBrien, B. J., & Briggs, A. H. (2004) · Health Economics · doi:10.1002/hec.903 · Cited by 946 · see citing works
Mining the plasma proteome for cancer biomarkers
Hanash, S., Pitteri, S. J., & Faça, V. M. (2008) · Nature · doi:10.1038/nature06916 · Cited by 893 · see citing works
Weinstein, M. C., Torrance, G. W., & McGuire, A. J. (2009) · Value in Health · doi:10.1111/j.1524-4733.2009.00515.x · Cited by 750 · see citing works
Delivering affordable cancer care in high-income countries
Sullivan, R., Peppercorn, J., Sikora, K., Zalcberg, J., Meropol, N. J., Amir, E., Khayat, D., Boyle, P., Autier, P., Tannock, I. F., et al. (2011) · The Lancet Oncology · doi:10.1016/s1470-2045(11)70141-3 · Cited by 718 · cited 2× · see citing works
“When the timing of treatment is important for achieving successful results, the costs of cancer care increases due to a higher risk of over-utilisation of diagnostic procedures or treatments.(26,27) Even if a diagnostic test in itself adds to these costs, the tests can create additional value in a socioeconomic perspe…”
BackgroundChari, S. T., Leibson, C. L., Rabe, K. G., Timmons, L. J., Ransom, J. E., de Andrade, M., & Petersen, G. M. (2007) · Gastroenterology · doi:10.1053/j.gastro.2007.10.040 · Cited by 519 · see citing works
Validation of the 6 th edition AJCC pancreatic cancer staging system
Bilimoria, K. Y., Bentrem, D. J., Ko, C. Y., Ritchey, J. D., Stewart, A. K., Winchester, D. P., & Talamonti, M. S. (2007) · Cancer · doi:10.1002/cncr.22852 · Cited by 424 · see citing works
A list of candidate cancer biomarkers for targeted proteomics.
Polanski, M., & Anderson, N. L. (2007) · PubMed Central · Cited by 350 · see citing works
Value based pricing for NHS drugs: an opportunity not to be missed?
Claxton, K., Briggs, A. H., Buxton, M. J., et al. (2008) · BMJ · doi:10.1136/bmj.39434.500185.25 · Cited by 230 · see citing works
Advances in diagnosis, treatment and palliation of pancreatic carcinoma: 1990-2010
Sharma, C. (2011) · World Journal of Gastroenterology · doi:10.3748/wjg.v17.i7.867 · Cited by 214 · see citing works
Assessing Quality in Decision Analytic Cost-Effectiveness Models
Sculpher, M. J., Fenwick, E. A. L., & Claxton, K. (2000) · PharmacoEconomics · doi:10.2165/00019053-200017050-00005 · Cited by 211 · see citing works
A List of Candidate Cancer Biomarkers for Targeted Proteomics
Polanski, M., & Anderson, N. L. (2006) · Biomarker Insights · doi:10.1177/117727190600100001 · Cited by 189 · see citing works
Feasibility and Yield of Screening in Relatives From Familial Pancreatic Cancer Families
Ludwig, E., Olson, S. H., Bayuga, S., Simon, J. A., Schattner, M. A., Gerdes, H., Allen, P. J., Jarnagin, W. R., & Kurtz, R. C. (2011) · The American Journal of Gastroenterology · doi:10.1038/ajg.2011.65 · Cited by 165 · see citing works
Detection of pancreatic cancer using antibody microarray‐based serum protein profiling
Ingvarsson, J., Wingren, C., Carlsson, A., et al. (2008) · PROTEOMICS · doi:10.1002/pmic.200701167 · Cited by 131 · see citing works
Burström, K., Johannesson, M., & Diderichsen, F. (2005) · Health Policy · doi:10.1016/j.healthpol.2005.06.011 · Cited by 127 · see citing works
Claxton, K. (2007) · Health Economics · doi:10.1002/hec.1249 · Cited by 114 · see citing works
Identification of Serum Biomarker Signatures Associated with Pancreatic Cancer
Wingren, C., Gerdtsson, A. S., Segersvärd, R., Carlsson, A., Andersson, R. E., Löhr, M. J., & Borrebaeck, C. A. K. (2012) · Cancer Research · doi:10.1158/0008-5472.can-11-2883 · Cited by 111 · see citing works
Self-citationHealth-Related Quality of Life in Patients with Pancreatic Cancer
Müller‐Nordhorn, J., Roll, S., Böhmig, M., Nocon, M., Reich, A., Braun, C., Noesselt, L., Wiedenmann, B. J., Willich, S. N., & Brüggenjürgen, B. (2006) · Digestion · doi:10.1159/000098177 · Cited by 73 · see citing works
Early Modelling for Assessing Health and Economic Outcomes of Drug Therapy
Annemans, L., Genesté, B., & Jolain, B. (2000) · Value in Health · doi:10.1046/j.1524-4733.2000.36007.x · Cited by 60 · see citing works
Early onset pancreatic cancer: a controlled trial.
Tingstedt, B., Weitkämper, C., & Andersson, R. E. (2011) · Europe PMC (PubMed Central) · Cited by 53 · see citing works
Self-citationScreening of High-Risk Families for Pancreatic Cancer
Greenhalf, W., Grocock, C., Harcus, M., & Neoptolemos, J. P. (2009) · Pancreatology · doi:10.1159/000210262 · Cited by 50 · see citing works
Screening for Pancreatic Cancer in High-Risk Individuals: A Call for Endoscopic Ultrasound
Larghi, A., Verna, E. C., Lecca, P. G., & Costamagna, G. (2009) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-08-1966 · Cited by 43 · see citing works
Pancreatic Cancer, Healthcare Cost, and Loss of Productivity: A Register‐based Approach
Tingstedt, B., Andersson, E., Flink, A., Bolin, K., Lindgren, B., & Andersson, R. E. (2011) · World Journal of Surgery · doi:10.1007/s00268-011-1208-2 · Cited by 41 · see citing works
Self-citationCost‐Utility Estimation of Surgical Treatment of Pancreatic Carcinoma Aimed at Cure
Ljungman, D., Lundholm, K., & Hyltander, A. G. (2010) · World Journal of Surgery · doi:10.1007/s00268-010-0883-8 · Cited by 29 · see citing works
Transferring proteomic discoveries into clinical practice
Borrebaeck, C. A. K., & Wingren, C. (2009) · Expert Review of Proteomics · doi:10.1586/14789450.6.1.11 · Cited by 28 · see citing works
Self-citationPersson, U., Svensson, J., & Pettersson, B. (2012) · Applied Health Economics and Health Policy · doi:10.2165/11633930-000000000-00000 · Cited by 27 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- Claxton K. Oft, Vbp: Qed? Health Econ 2007;16:545-58.
- Tingstedt B, Weitk€ amper C, Andersson R. Early Onset Pancreatic Cancer-comparison against matched controls. Annals of Gastroenterology 2011;24:206-12.
Cited by
Sorted by citations
Palucka, A. K., & Coussens, L. M. (2016) · Cell · doi:10.1016/j.cell.2016.01.049 · Cited by 843 · see citing works
Early detection of pancreatic cancer
Pereira, S. P., Oldfield, L., Ney, A., Hart, P. A., Keane, M. G., Pandol, S. J., Li, D., Greenhalf, W., Jeon, C. Y., Koay, E. J., et al. (2020) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(19)30416-9 · Cited by 482 · see citing works
Combining Machine Learning and Nanofluidic Technology To Diagnose Pancreatic Cancer Using Exosomes
Ko, J., Bhagwat, N., Yee, S. S., Ortiz, N., Sahmoud, A., Black, T., Aiello, N. M., McKenzie, L., O’Hara, M., Redlinger, C., et al. (2017) · ACS Nano · doi:10.1021/acsnano.7b05503 · Cited by 249 · see citing works
Biomarkers for early diagnosis of pancreatic cancer
Jenkinson, C., Earl, J., Ghaneh, P., Halloran, C., Carrato, A., Greenhalf, W., Neoptolemos, J., & Costello, E. (2015) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.2015.965145 · Cited by 42 · see citing works
Precision medicine in pancreatic cancer — fact or fiction?
Seufferlein, T., & Mayerle, J. (2016) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2015.215 · Cited by 35 · see citing works
Surveillance for neoplasia in the pancreas
Overbeek, K. A., Cahen, D. L., Canto, M. I., & Bruno, M. J. (2016) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2016.10.013 · Cited by 28 · see citing works
- Authors
- Ghatnekar, O., Andersson, R., Svensson, M., Persson, U., Ringdahl, U., Zeilon, P., & Borrebaeck, C. A. K.
- Affiliations
- Swedish Institute for Health Economics (SE)
- Lund University (SE)
- Corresponding author
- Svensson, Marianne
- Venue
- International Journal of Cancer
- Publisher
- Wiley
- Published
- 2013-06-10
- Volume
- 133
- Issue
- 10
- Pages
- 2392-2397
- ISSN
- 0020-7136 (ISSN-L)
- 1097-0215
- OpenAlex
- W1765673603
- Cited by
- 85
- References
- 28
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 26 · 2023: 5 · 2022: 7 · 2021: 7 · 2020: 7 · 2018: 4 · 2017: 8 · 2016: 5 · 2015: 4 · 2014: 4 · 2013: 1
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Lunds Universitet
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- pancreatic cancer, early diagnosis, cancer screening, cost-effectiveness, biomarker signatures, quality-adjusted life years, diabetic patients, tumor stage, diagnostic accuracy, watch-and-wait strategy
- MeSH terms
- Aged, Cost-Benefit Analysis, Humans, Middle Aged, Pancreatic Neoplasms, Biomarkers, Tumor, Health Care Costs, Models, Economic, Proteomics, Early Detection of Cancer
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