Which Lynch syndrome screening programs could be implemented in the "real world"? A systematic review of economic evaluations.

摘要: Lynch syndrome (LS) screening can significantly reduce cancer morbidity and mortality in mutation carriers. Our aim was to identify cost-effective LS programs that be implemented the “real world.” We performed a systematic review of full economic evaluations genetic for different target populations; health outcomes were estimated life-years gained or quality-adjusted life-years. Overall, 20 studies included review. Based on study populations, we identified six categories program: colorectal (CRC)–based, endometrial cancer–based, general population–based, family registry–based, cascade testing–based, genetics clinic–based programs. an in-depth analysis CRC-based programs, classifying them into three additional subcategories: universal, age-targeted, selective. In five studies, universal based immunohistochemistry, either alone combination with BRAF test, compared no screening, while two age-targeted cutoff 70 years when lower age thresholds. Universal <70 years–age-targeted are should