Table 4 Mean incremental health outcomes of genetic services compared to no presymptomatic health services
Base case | Least favourable | Most favourable | ||||
|---|---|---|---|---|---|---|
Risk level and clinical strategy | Life years | QALYs | Life years | QALYs | Life years | QALYs |
High-risk BRCA1/2 carriers | ||||||
Genetic services | 1.07 | 0.69 | 0.07 | 0.03 | 1.72 | 0.94 |
Surveillance | 0.99 | 0.68 | 0.06 | 0.04 | 1.57 | 1.05 |
Mastectomy | 1.61 | 0.61 | 0.23 | −0.06 | 1.83 | 0.76 |
Oophorectomy | 1.36 | 1.67 | — | — | 1.72 | 1.91 |
Mastectomy and oophorectomy | 1.61 | 0.003 | — | — | 1.83 | 0.15 |
High-risk carriers of an unidentified mutation | ||||||
Genetic services | 0.34 | 0.22 | 0.02 | 0.009 | 0.55 | 0.27 |
Surveillance | 0.32 | 0.21 | 0.02 | 0.02 | 0.50 | 0.33 |
Mastectomy | 0.52 | 0.05 | 0.08 | −0.11 | 0.59 | 0.10 |
Oophorectomy | 0.41 | 1.21 | — | — | 0.54 | 1.29 |
Mastectomy and oophorectomy | 0.52 | −0.55 | — | — | 0.59 | −0.51 |
Moderate risk | ||||||
Genetic services | 0.07 | 0.05 | 0.00 | 0.00 | 0.2 | 0.11 |
Surveillance | 0.07 | 0.05 | 0.00 | 0.00 | 0.2 | 0.11 |
All at increased risk | ||||||
Genetic services | 0.09 | 0.06 | 0.001 | 0.0005 | 0.18 | 0.12 |
