Prevention versus early detection for long-term control of melanoma and keratinocyte carcinomas: a cost-effectiveness modelling study.
cost-effectiveness
early detection
keratinocyte carcinomas
melanoma
primary prevention
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
26 02 2020
26 02 2020
Historique:
entrez:
29
2
2020
pubmed:
29
2
2020
medline:
10
4
2021
Statut:
epublish
Résumé
To compare the long-term economic impact of melanoma prevention by sun protection, with the corresponding impact of early detection of melanoma to decrease melanoma deaths. Cost-effectiveness analysis using Markov cohort model. Data were primarily from two population-based randomised controlled trials, epidemiological and costing reports, and included flow-on effects for keratinocyte cancers (previously non-melanoma skin cancers) and actinic keratoses. Queensland, Australia. Men and women with a mean age 50 years modelled for 30 years. Daily sunscreen use (prevention) compared with annual clinical skin examinations (early detection) and comparing these in turn with the status quo. Costs, counts of melanoma, melanoma deaths, keratinocyte cancers, life years and quality-adjusted life years. Per 100 000 individuals, for early detection, primary prevention and without intervention, there were 2446, 1364 and 2419 new melanomas, 556, 341 and 567 melanoma deaths, 64 452, 47 682 and 64 659 keratinocyte cancers and £493.5, £386.4 and £406.1 million in economic costs, respectively. There were small differences between prevention and early detection in life years saved (0.09%) and quality-adjusted life years gained (0.10%). Compared with early detection of melanoma, systematic sunscreen use at a population level will prevent substantial numbers of new skin tumours, melanoma deaths and save healthcare costs. Primary prevention through daily use of sunscreen is a priority for investment in the control of melanoma.
Identifiants
pubmed: 32107270
pii: bmjopen-2019-034388
doi: 10.1136/bmjopen-2019-034388
pmc: PMC7202703
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e034388Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: Author LG received conference travel, registration and accommodation for presenting a preliminary version of these findings at the 4th International UV and Skin Cancer Prevention Conference in May 2018 Toronto.
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