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Cancer Prevention Research
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Review

A Systematic Review on Cost-effectiveness Studies Evaluating Ovarian Cancer Early Detection and Prevention Strategies

Gaby Sroczynski, Artemisa Gogollari, Felicitas Kuehne, Lára R. Hallsson, Martin Widschwendter, Nora Pashayan and Uwe Siebert
Gaby Sroczynski
1Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.
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Artemisa Gogollari
1Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.
2Division of Health Technology Assessment, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria.
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Felicitas Kuehne
1Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.
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Lára R. Hallsson
1Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.
2Division of Health Technology Assessment, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria.
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Martin Widschwendter
3Department of Women's Cancer, University College London, London, United Kingdom.
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Nora Pashayan
4Department of Applied Health Research, University College London, London, United Kingdom.
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Uwe Siebert
1Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.
2Division of Health Technology Assessment, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria.
5Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
6Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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  • For correspondence: public-health@umit.at
DOI: 10.1158/1940-6207.CAPR-19-0506 Published May 2020
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Abstract

Ovarian cancer imposes a substantial health and economic burden. We systematically reviewed current health-economic evidence for ovarian cancer early detection or prevention strategies. Accordingly, we searched relevant databases for cost-effectiveness studies evaluating ovarian cancer early detection or prevention strategies. Study characteristics and results including quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICER) were summarized in standardized evidence tables. Economic results were transformed into 2017 Euros. The included studies (N = 33) evaluated ovarian cancer screening, risk-reducing interventions in women with heterogeneous cancer risks and genetic testing followed by risk-reducing interventions for mutation carriers. Multimodal screening with a risk-adjusted algorithm in postmenopausal women achieved ICERs of 9,800–81,400 Euros/QALY, depending on assumptions on mortality data extrapolation, costs, test performance, and screening frequency. Cost-effectiveness of risk-reducing surgery in mutation carriers ranged from cost-saving to 59,000 Euros/QALY. Genetic testing plus risk-reducing interventions for mutation carriers ranged from cost-saving to 54,000 Euros/QALY in women at increased mutation risk. Our findings suggest that preventive surgery and genetic testing plus preventive surgery in women at high risk for ovarian cancer can be considered effective and cost-effective. In postmenopausal women from the general population, multimodal screening using a risk-adjusted algorithm may be cost-effective.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Prevention Research Online (http://cancerprevres.aacrjournals.org/).

  • Cancer Prev Res 2020;13:429–42

  • Received November 7, 2019.
  • Revision received January 1, 2020.
  • Accepted February 14, 2020.
  • Published first February 18, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Prevention Research: 13 (5)
May 2020
Volume 13, Issue 5
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A Systematic Review on Cost-effectiveness Studies Evaluating Ovarian Cancer Early Detection and Prevention Strategies
Gaby Sroczynski, Artemisa Gogollari, Felicitas Kuehne, Lára R. Hallsson, Martin Widschwendter, Nora Pashayan and Uwe Siebert
Cancer Prev Res May 1 2020 (13) (5) 429-442; DOI: 10.1158/1940-6207.CAPR-19-0506

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A Systematic Review on Cost-effectiveness Studies Evaluating Ovarian Cancer Early Detection and Prevention Strategies
Gaby Sroczynski, Artemisa Gogollari, Felicitas Kuehne, Lára R. Hallsson, Martin Widschwendter, Nora Pashayan and Uwe Siebert
Cancer Prev Res May 1 2020 (13) (5) 429-442; DOI: 10.1158/1940-6207.CAPR-19-0506
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