Screening every new colon cancer patient for a particular familial disorder extends lives at a reasonable cost, say Stanford University School of Medicine researchers. The team hopes the results will encourage more medical centers to adopt widespread screening policies.
Approximately 3 to 5 percent of colorectal tumors are caused by a heritable condition called Lynch syndrome, which greatly increases the odds of colon and other cancers in a person’s lifetime. Siblings and children of someone with Lynch syndrome each have a 50 percent chance of carrying the mutation, so the first diagnosis in a family reveals the risk for many relatives. But the discovery can save lives.
“This is a situation where, if you find out genetic information, you can improve your outcome,” said Uri Ladabaum, MD, associate professor of gastroenterology and hepatology, and lead author of the study. Lynch syndrome patients can take defensive steps (such as yearly colonoscopies) that can either prevent cancer or alert them to get cancer treatment early, when it has the best chance of working. Stanford and several other U.S. medical centers now test all colon tumors to identify families with the genetic disorder, but in an era of shrinking wallets and booming health-care costs, some may wonder whether these policies are worth it.
“We were interested in whether it would be cost-effective to test a lot of colon tumors to find the few that are due to Lynch syndrome and, if so, what would be the most cost-effective strategy,” said Ladabaum. He and his colleagues used computer simulations to compare the years of lives gained and the money spent if all new cases of colorectal cancer were tested for Lynch syndrome. They found that such screening programs can reduce cancer deaths at a price within the typical range of U.S. health-care costs. The study was published in the July 19 issue of Annals of Internal Medicine. Read more…