Wang Louise, Levinson Rachel, Mezzacappa Catherine, Katona Bryson W
Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, USA.
VA Connecticut Healthcare System, West Haven, CT, USA.
Fam Cancer. 2024 Aug;23(3):351-360. doi: 10.1007/s10689-024-00392-1. Epub 2024 May 25.
Individuals with hereditary pancreatic cancer risk include high risk individuals (HRIs) with germline genetic susceptibility to pancreatic cancer (PC) and/or a strong family history of PC. Previously, studies have shown that PC surveillance in HRIs can downstage PC diagnosis and extend survival leading to pancreatic surveillance being recommended for certain HRIs. However, the optimal surveillance strategy remains uncertain, including which modalities should be used for surveillance, how frequently should surveillance be performed, and which sub-groups of HRIs should undergo surveillance. Additionally, in the ideal world PC surveillance should also be cost-effective. Cost-effectiveness analysis is a valuable tool that can consider the costs, potential health benefits, and risks among various PC surveillance strategies. In this review, we summarize the cost-effectiveness of various PC surveillance strategies for HRIs for hereditary pancreatic cancer and provide potential avenues for future work in this field. Additionally, we include cost-effectiveness studies among individuals with new-onset diabetes (NoD), a high-risk group for sporadic PC, as a comparison.
遗传性胰腺癌风险个体包括对胰腺癌(PC)具有种系遗传易感性和/或有强烈胰腺癌家族史的高危个体(HRIs)。此前,研究表明,对HRIs进行胰腺癌监测可降低胰腺癌诊断分期并延长生存期,因此建议对某些HRIs进行胰腺监测。然而,最佳监测策略仍不确定,包括应使用哪些方式进行监测、监测频率应为多少以及哪些HRIs亚组应接受监测。此外,在理想情况下,胰腺癌监测还应具有成本效益。成本效益分析是一种有价值的工具,可考虑各种胰腺癌监测策略的成本、潜在健康益处和风险。在本综述中,我们总结了针对遗传性胰腺癌HRIs的各种胰腺癌监测策略的成本效益,并为该领域未来的工作提供了潜在途径。此外,作为比较,我们还纳入了新发糖尿病(NoD)个体(散发性胰腺癌的高危群体)的成本效益研究。