Health Economic Evaluations of Circulating Tumor DNA Testing for Cancer Screening: Systematic Review

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-02-05 DOI:10.1002/cam4.70641

Mingjun Rui, Yingcheng Wang, Joyce H. S. You

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引用次数: 0

Abstract

Background

Cancer detection remains a significant global healthcare challenge, and circulating tumor DNA (ctDNA) is a biomarker for noninvasive cancer screening.

Objective

This systematic review aimed to describe health economic evaluations of ctDNA for cancer screening.

Methods

A comprehensive literature search was performed (following PRISMA guidelines) across MEDLINE, Embase, APA PsycINFO, Cochrane Library, Web of Science, and the Center for Review and Dissemination. The review included full-scale health economic analyses such as cost–effectiveness, cost–utility, cost–benefit, and cost–consequence analyses. The quality of the included reports was assessed using CHEERS 2022 standards, and each report was categorized as excellent, very good, good, or insufficient.

Results

Eighteen studies were selected, including four ctDNA tests (EBV-DNA, cf-DNA, mSEPT9, and mt-sDNA) for three types of cancer screening: nasopharyngeal carcinoma (NPC) (2; 11.11%), breast cancer (BC) (1; 5.56%), and colorectal cancer (CRC) (15; 83.33%). Five studies (27.78%) found ctDNA cost-effective for CRC screening (mt-sDNA (with higher uptake than conventional tests) versus fecal immunochemical testing (FIT) or colonoscopy (n = 4); mSEPT9 versus computed tomography colonoscopy (CTC) (n = 1)). Thirteen studies (72.22%) found ctDNA not cost-effective for NPC (EBV-DNA versus no screening (n = 2)); BC (cf-DNA versus conventional testing (n = 1)); CRC (mSEPT9 versus FIT or colonoscopy (n = 2)); mt-sDNA versus FIT or colonoscopy (n = 5); mSEPT9 or mt-sDNA versus conventional tests (n = 3)). The CHEERS assessment found all reports in the “very good” category.

Conclusion

All ctDNA tests were generally not cost-effective comparing to conventional screening methods, except when the mt-sDNA uptake was higher than the comparators or when mSEPT9 was compared with CTC.

Trial Registration

CRD42023477732

Abstract Image

查看原文本刊更多论文

循环肿瘤DNA检测用于癌症筛查的健康经济评价：系统综述。

背景：癌症检测仍然是一项重大的全球医疗保健挑战，循环肿瘤DNA （ctDNA）是一种非侵入性癌症筛查的生物标志物。目的：本系统综述旨在描述ctDNA用于癌症筛查的健康经济评价。方法：在MEDLINE、Embase、APA PsycINFO、Cochrane图书馆、Web of Science和Center for Review and Dissemination等网站（遵循PRISMA指南）进行全面的文献检索。审查包括全面的卫生经济分析，如成本效益、成本效用、成本效益和成本后果分析。纳入报告的质量使用CHEERS 2022标准进行评估，每个报告被分类为优秀、非常好、好或不充分。结果：选择了18项研究，包括4项ctDNA检测（EBV-DNA、cf-DNA、mSEPT9和mt-sDNA），用于三种类型的癌症筛查：鼻咽癌（NPC） (2；11.11%)，乳腺癌（BC） (1；5.56%)，结直肠癌（CRC） (15；83.33%)。5项研究（27.78%）发现ctDNA用于结直肠癌筛查(mt-sDNA（摄取高于传统检测）与粪便免疫化学检测（FIT）或结肠镜检查（n = 4）相比具有成本效益；mSEPT9与计算机断层结肠镜检查（CTC）（n = 1）)。13项研究（72.22%）发现ctDNA对鼻咽癌没有成本效益（EBV-DNA与未筛查（n = 2））；BC （cf-DNA对比常规检测（n = 1））；CRC （mSEPT9与FIT或结肠镜检查（n = 2））；mt-sDNA对比FIT或结肠镜检查（n = 5）；mSEPT9或mt-sDNA对比常规检测（n = 3）)。干杯评估发现所有的报告都在“非常好”的类别。结论：除了mt-sDNA摄取高于对照物或mSEPT9与CTC比较外，所有ctDNA检测与常规筛查方法相比一般都不具有成本效益。试验注册：CRD42023477732。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.