Cancer Modelling Group

Effectiveness and cost-effectiveness of systematic screening for Lynch Syndrome (LS) in Australia

Date commenced: 01/2015

Project supporters:

  • National Health & Medical Research Council

Research Project Main Image

Project members:

Project main description:

The aim of this project is to evaluate the effectiveness and cost-effectiveness of screening for Lynch syndrome (LS) in Australia. LS is an autosomal dominant disorder characterised by a substantially increased lifetime risk of developing a range of cancers, particularly colorectal, endometrial and ovarian cancers. Once LS cases are identified, cascade testing can be offered to relatives, and a range of preventative options including surveillance and prophylactic surgery can be offered. Although screening of incident colorectal cancers has been evaluated at an Area Health Service level in NSW and implemented at a state level in WA, no national approach has been established, and genetic testing for LS is not reimbursed by Medicare. Recently, a major UK Health Technology Assessment (HTA) concluded that screening incident colorectal cancers for LS would be cost-effective for the UK National Health Service. In the current project, we will perform cost-effectiveness evaluation of screening for LS mutation carriers (with cascade testing of relatives) in progressively broader populations in Australia (colorectal cancers, +endometrial cancers, +ovarian cancers, +other LS-related cancers, +general population); this systematic incremental approach to LS evaluation has not previously been used in any setting. We will bring together an experienced multidisciplinary team and adapt a range of existing tools for the evaluation, including a detailed model of colorectal cancer developed with Dutch trial data, and the UK HTA family genetic model. The modelling will be supported by a related program of systematic review, a costing study, and a series of consumer workshops. The outcome will consist of a set of evidence-based recommendations for LS screening, which has potential to be used to support future submission to the Medical Services Advisory Committee (MSAC) for reimbursement of LS screening in the defined population groups for which LS screening is cost-effective in Australia.

Project supporters:

  • National Health & Medical Research Council