Original ArticlePancreatobiliaryCost-Effectiveness of a Risk-Tailored Pancreatic Cancer Early Detection Strategy Among Patients With New-Onset Diabetes
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Section snippets
Methods
All authors had access to the study data and reviewed and approved the final manuscript. This study did not involve any human subjects research and did not require institutional review board review.
Results
There were 89,881 individuals in our published THIN study cohort with NoD diagnosed at 50 years of age or older. The cumulative incidence of pancreatic cancer was 0.42% over the 3 years after a DM diagnosis. The average age of the cohort was 66.4 years old (SD, ±9.6 y), and 53% of the cohort was male. For each of the 6 risk thresholds used to define the high-risk group, we derived the corresponding proportion of NoD patients in the high-risk group as well as the 3-year predicted risks of being
Discussion
Our base-case analysis showed that at a WTP threshold of $150,000/QALY, early detection for pancreatic cancer using a risk threshold of 1% to define a high-risk group was cost effective. At a more conservative WTP threshold of $100,000/QALY, early detection at the 2% risk threshold was cost effective. For both WTP thresholds at 150,000 and 100,000/QALY, local cancer stage shift (defined as the percentage of patients diagnosed with local cancer at the time of screening), had the greatest impact
CRediT Authorship Contributions
Louise Wang (Conceptualization: Equal; Data curation: Lead; Formal analysis: Lead; Investigation: Lead; Writing – original draft: Lead; Writing – review & editing: Equal)
Frank Scott (Conceptualization: Supporting; Formal analysis: Supporting; Writing – review & editing: Supporting)
Ben Boursi (Conceptualization: Supporting; Writing – review & editing: Supporting)
Kim Reiss (Conceptualization: Supporting; Writing – review & editing: Supporting)
Sankey Williams (Conceptualization: Supporting;
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Conflicts of interest These authors disclose the following: Dr Louise Wang has received research support from the NIH T32DK007740 Training grant in GI Epidemiology. Frank I. Scott has received grants from Takeda Pharmaceuticals USA, Janssen Pharmaceuticals, the National Institutes of Health, and the Crohn’s and Colitis Foundation, and has received personal fees from PRIME, Inc, Janssen Pharmaceuticals, Takeda Pharmaceuticals, and Merck Pharmaceuticals; and Kim Reiss has received research support from Lilly Oncology, BMS, GSK, and Clovis Oncology. The remaining authors disclose no conflicts.