Decision-analytic evaluation of the comparative effectiveness and cost-effectiveness of strategies to prevent breast and ovarian cancer in German women with BRCA-1/2 mutations

Hallsson, Lára R.; Sroczynski, Gaby; Engel, Jutta; Siebert, Uwe

doi:10.1186/s12885-023-10956-6

Table 1 Model input data. Natural history model parameters and effect measures of prophylactic surgeries used to populate the model

From: Decision-analytic evaluation of the comparative effectiveness and cost-effectiveness of strategies to prevent breast and ovarian cancer in German women with BRCA-1/2 mutations

Progression		Annual transition probability		Reference
From	To
*Age-specific progression from well to undetected breast cancer pT1*
		Age
Well	Und. pT1	20–29	0.0002–0.0020	Antoniou et al., 2003 [2]*
		30–39	0.0106–0.0185
		40–49	0.0326–0.0688
		50–59	0.0705–0.0723
		60–69	0.0740–0.0757
		70–79	0.0666 − 0.0638
		80–89	0.0609 − 0.0583
		90–99	0.0557 − 0.0531
*Age-specific progression from well to undetected ovarian cancer stage FIGO I*
		Age
Well	Und. FIGO I	20–29	0.000015-0.00002	Antoniou et al., 2003 [2]*
		30–39	0.0019–0.0025
		40–49	0.0119–0.0178
		50–59	0.0242–0.0242
		60–69	0.0348–0.0433
		70–79	0.0465–0.0553
		80–89	0.0497 − 0.0441
		90–99	0.0385 − 0.0328
*Progression of undetected cancer to more severe stages*
*Breast cancer*				§
Und. pT1	Und.pT2	0.205
Und. pT2	Und. pT3	0.25
Und. pT3	Und.pT4	0.60
*Ovarian cancer*
Und. FIGO I	Und. FIGO II	0.70
Und. FIGO II	Und. FIGO III	0.93
Und. FIGO III	Und. FIGO IV	0.99
*Symptomatic detection: Transition from undetected to detected cancer*
Und. pT1	Det. pT1	0.23		§
Und. pT2	Det. pT2	0.55
Und. pT3	Det. pT3	0.60
Und. pT4	Det. pT4	1.00
Und. FIGO I	Det. FIGO I	0.15
Und. FIGO II	Det. FIGO II	0.15
Und. FIGO III	Det. FIGO III	0.72
Und. FIGO IV	Det. FIGO IV	0.95
*Cancer survival and mortality*
*Disease- and stage-specific survival (year 1–10)* ^†
pT1	Survivor (pT1)	1.0–0.988		MCR, 2017 [17]
pT2	Survivor (pT2)	0.991 − 0.966		MCR, 2017 [17]
pT3	Survivor (pT3)	0.911–0.939		MCR, 2017 [17]
pT4	Survivor (pT4)	0.735–0.874		MCR, 2017 [17]
FIGO I	Survivor (FIGO I)	0.981 − 0.956		MCR, 2017 [18]
FIGO II	Survivor (FIGO II)	0.918–0.988		MCR, 2017 [18]
FIGO III	Survivor (FIGO III)	0.809–0.963		MCR, 2017 [18]
FIGO IV	Survivor (FIGO IV)	0.576–0.989		MCR, 2017 [18]
*Effect measures: Relative risk (surgery vs. no surgery)* ^‡
*Breast cancer*
PBM		0.070		Rebbeck et al., 2004 [41]
PBSO		0.500		Rebbeck et al., 2002 [7]
PBM + PBSO		0.039		Rebbeck et al., 2004 [41]
*Ovarian cancer*
PBSO		0.038		Rebbeck et al., 2002 [7]

det.: detected; FIGO I-IV: ovarian cancer stage FIGO 1–4; MCR: Munich Cancer Registry; PBM: Prophylactic bilateral mastectomy; PBSO: Prophylactic bilateral salpingo-oophorectomy; pT1-4: breast cancer stage pT1-pT4; und.: undetected, vs.: versus
* Calibrated to BRCA-1/2 specific incidence rates reported in Antoniou et al. 2003 [2] (see Additional file 1: Table S1)
§ Progression probabilities for each stage and detection probabilities were assessed through calibration to incidence rates and stage distribution of breast and ovarian cancer respectively
† Annual stage-specific survival probabilities (year 1–10 after diagnosis) were used to populate the model. Here shown as a range
‡ All women are assumed to receive standard care (i.e., intensified surveillance of breast cancer)

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ISSN: 1471-2407

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