COST EFFECTIVENESS OF GENETIC SCREENING FOR COLON CANCER

描述(申请人的描述)：基因筛查的方法 遗传性非息肉病性结直肠癌(HNPCC)发展迅速， 可能很快就会从实验室和遗传学专业中心转移到 全科医生办公室和其他门诊网站。现在有一个 需要更好地了解基因筛查对HNPCC的影响 经济和以患者为中心的生活质量观点。作为对.的回应 NCI的职业发展奖(Howard Temin奖)，候选人 建议：(1)开发灵活的数学仿真模型，以 评估替代基因筛查的成本效益和 HNPCC敏感性的筛查后监测策略；(2)估计 HNPCC基因筛查对健康相关生活质量的影响 那些接受测试的人。该研究项目预计 制定结直肠癌登记制度以应对国家癌症 RFA CA-96-011研究所，“流行病学合作家庭登记处” 本登记处的患者将被招募到 参与与健康相关的生活质量调查。作为该计划的一部分 职业发展计划，候选人将选修遗传学和 公共卫生和社区医学学院遗传流行病学 在华盛顿大学。这位情侣的导师妮可·厄本 SC.D.，在数学建模和指挥方面拥有丰富的经验 卵巢癌和乳腺癌的成本-效果分析。候选人的 长期目标是(1)为应用开发通用的研究指南 常见病基因筛查的成本-效果分析 恶性肿瘤；(2)利用成本-效果分析的结果 基因筛查是临床实践发展的一部分 针对初级保健的基因筛查指南 医生。

DESCRIPTION (Applicant's Description): Methods of genetic screening for hereditary nonpolyposis colorectal cancer (HNPCC) are rapidly developing, and may soon move from the laboratory and genetics specialty centers to generalist physicians' offices and other outpatient sites. There is now a need to better understand the impact of genetic screening for HNPCC from an economic and patient-centered quality-of-life perspective. In response to the NCI's Career Development Award (Howard Temin Award), the candidate proposes to: (1) develop a flexible mathematical simulation model to estimate the cost-effectiveness of alternative genetic screening and postscreening surveillance strategies for HNPCC susceptibility; (2) estimate the impact of genetic screening for HNPCC on health-related quality of life of those who undergo testing. The research project anticipates the development of a colorectal cancer registry in response to National Cancer Institute RFA CA-96-011, "Cooperative Family Registry for Epidemiologic Studies of Colon Cancer." Patients from this registry will be recruited to participate in the health-related quality-of-life survey. As part of the career development plan, the candidate will take course work in genetics and genetic epidemiology from The School of Public Health and Community Medicine at the University of Washington. The c a ndidate's mentor, Nicole Urban, Sc.D., has extensive experience in mathematical modeling and conducting cost-effectiveness analysis of ovarian and breast cancer. The candidate's long-term goals are to (1) develop general research guidelines for applying cost-effectiveness analysis to genetic screening for commonly acquired malignancies; (2) utilize the results from cost-effectiveness analyses of genetic screening tests as part of the development of clinical practice guidelines for genetic screening that are directed at primary care physicians.