Health State Utilities Associated with False-Positive Cancer Screening Results.


Journal

PharmacoEconomics - open
ISSN: 2509-4254
Titre abrégé: Pharmacoecon Open
Pays: Switzerland
ID NLM: 101700780

Informations de publication

Date de publication:
08 Jan 2024
Historique:
accepted: 14 09 2023
medline: 8 1 2024
pubmed: 8 1 2024
entrez: 8 1 2024
Statut: aheadofprint

Résumé

Early cancer detection can significantly improve patient outcomes and reduce mortality rates. Novel cancer screening approaches, including multi-cancer early detection tests, have been developed. Cost-utility analyses will be needed to examine their value, and these models require health state utilities. The purpose of this study was to estimate the disutility (i.e., decrease in health state utility) associated with false-positive cancer screening results. In composite time trade-off interviews using a 1-year time horizon, UK general population participants valued 10 health state vignettes describing cancer screening with true-negative or false-positive results. Each false-positive vignette described a common diagnostic pathway following a false-positive result suggesting lung, colorectal, breast, or pancreatic cancer. Every pathway ended with a negative result (no cancer detected). The disutility of each false positive was calculated as the difference between the true-negative and each false-positive health state, and because of the 1-year time horizon, each disutility can be interpreted as a quality-adjusted life-year decrement associated with each type of false-positive experience. A total of 203 participants completed interviews (49.8% male; mean age = 42.0 years). The mean (SD) utility for the health state describing a true-negative result was 0.958 (0.065). Utilities for false-positive health states ranged from 0.847 (0.145) to 0.932 (0.059). Disutilities for false positives ranged from - 0.031 to - 0.111 (- 0.041 to - 0.111 for lung cancer; - 0.079 for colorectal cancer; - 0.031 to - 0.067 for breast cancer; - 0.048 to - 0.088 for pancreatic cancer). All false-positive results were associated with a disutility. Greater disutility was associated with more invasive follow-up diagnostic procedures, longer duration of uncertainty regarding the eventual diagnosis, and perceived severity of the suspected cancer type. Utility values estimated in this study would be useful for economic modeling examining the value of cancer screening procedures.

Identifiants

pubmed: 38189869
doi: 10.1007/s41669-023-00443-w
pii: 10.1007/s41669-023-00443-w
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : GRAIL, LLC
ID : EVA-26058

Informations de copyright

© 2024. The Author(s).

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Auteurs

Louis S Matza (LS)

Evidera, Bethesda, MD, USA. louis.matza@evidera.com.

Timothy A Howell (TA)

Evidera, Bethesda, MD, USA.

Eric T Fung (ET)

GRAIL, LLC., a subsidiary of Illumina Inc., Menlo Park, CA, USA.

Sam M Janes (SM)

UCL Respiratory, University College London, London, UK.

Michael Seiden (M)

Physician in Residence, GRAIL, LLC., Menlo Park, CA, USA.

Allan Hackshaw (A)

UCL Respiratory, University College London, London, UK.

Lincoln Nadauld (L)

Intermountain Healthcare, Salt Lake City, UT, USA.

Hayley Karn (H)

Evidera, London, UK.

Karen C Chung (KC)

GRAIL, LLC., a subsidiary of Illumina Inc., Menlo Park, CA, USA.

Classifications MeSH