{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:21:39Z","timestamp":1789042899140,"version":"build-2803163510"},"reference-count":83,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>We evaluated the potential cost-effectiveness of combined magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) screening for pancreatic ductal adenocarcinoma (PDAC) among populations at high risk for the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We used a microsimulation model of the natural history of PDAC to estimate the lifetime health benefits, costs, and cost-effectiveness of PDAC screening among populations with specific genetic risk factors for PDAC, including BRCA1 and BRCA2, PALB2, ATM, Lynch syndrome, TP53, CDKN2A, and STK11. For each high-risk population, we simulated 29 screening strategies, defined by starting age and frequency. Screening included MRI with follow-up EUS in a subset of patients. Costs of tests were based on Medicare reimbursement for MRI, EUS, fine-needle aspiration biopsy, and pancreatectomy. Cancer-related cost by stage of disease and phase of treatment was based on the literature. For each high-risk population, we performed an incremental cost-effectiveness analysis, assuming a willingness-to-pay (WTP) threshold of $100,000 US dollars (USD) per quality-adjusted life year (QALY) gained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>For men with relative risk (RR) 12.33 ( CDKN2A) and RR 28 ( STK11), annual screening was cost-effective, starting at age 55 and 40 years, respectively. For women, screening was only cost-effective for those with RR 28 ( STK11), with annual screening starting at age 45 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Combined MRI\/EUS screening may be a cost-effective approach for the highest-risk populations (among mutations considered, those with RR &gt;12). However, for those with moderate risk (RR, 5-12), screening would only be cost-effective at higher WTP thresholds (eg, $200K USD\/QALY) or with once-only screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op.23.00495","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T15:59:16Z","timestamp":1702396756000},"page":"278-290","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":18,"title":["Cost-Effectiveness Analysis of Screening for Pancreatic Cancer Among High-Risk Populations"],"prefix":"10.1200","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0905-7583","authenticated-orcid":true,"given":"Mary Linton B.","family":"Peters","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA"},{"name":"Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5263-756X","authenticated-orcid":true,"given":"Andrew","family":"Eckel","sequence":"additional","affiliation":[{"name":"Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1076-5563","authenticated-orcid":true,"given":"Claudia L.","family":"Seguin","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Ohio State University College of Medicine, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barak","family":"Davidi","sequence":"additional","affiliation":[{"name":"Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4465-0414","authenticated-orcid":true,"given":"David H.","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1872-996X","authenticated-orcid":true,"given":"Amy B.","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA"},{"name":"Department of Radiology, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pari V.","family":"Pandharipande","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Ohio State University College of Medicine, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"b1","volume-title":"Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2018 Sub (2000-2016) <Katrina\/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969-2017 Counties. Updated released April 2019, based on the November 2018 submission","author":"National Cancer Institute D, Surveillance Research Program","year":"2019"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.11.042"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.7401"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-15-0455"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djy024"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29664"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.72.3502"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31628"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.01489"},{"key":"b10","volume-title":"NCCN Guidelines: Pancreatic Adenocarcinoma","author":"National Comprehensive Cancer Network","year":"2021"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.6190"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-323611"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.05.035"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.0730"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181a86b2c"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2013.02.002"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.2147\/TACG.S51483"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1529"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/94.18.1365"},{"key":"b20","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/94.18.1358"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2004.028829"},{"key":"b22","doi-asserted-by":"publisher","DOI":"10.1080\/13651820600985325"},{"key":"b23","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.3340"},{"key":"b24","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000166"},{"key":"b25","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-09-3209"},{"key":"b26","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-319352"},{"key":"b27","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.14141282"},{"key":"b28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2015.11.005"},{"key":"b29","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2022.05.003"},{"key":"b30","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2018.07.009"},{"key":"b31","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra031623"},{"key":"b32","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.01.005"},{"key":"b33","volume-title":"Surveillance Research Program, Cancer Statistics Branch. Surveillance, Epidemiology, and End Results Results (SEER) Program DevCan Database","author":"National Cancer Institute","year":"2023"},{"key":"b34","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-011-1781-6"},{"key":"b35","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-017-0057-z"},{"key":"b36","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00244-7"},{"key":"b37","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.3852"},{"key":"b38","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001038"},{"key":"b39","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308008"},{"key":"b40","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.03.013"},{"key":"b41","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.171611"},{"key":"b42","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.65"},{"key":"b43","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.276"},{"key":"b44","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-010-9414-x"},{"key":"b45","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198709000-00014"},{"key":"b46","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2012.05.022"},{"key":"b47","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1010705"},{"key":"b48","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1989.01410070028006"},{"key":"b49","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000375"},{"key":"b50","doi-asserted-by":"publisher","DOI":"10.1016\/j.gassur.2006.08.018"},{"key":"b51","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506859"},{"key":"b52","first-page":"340","volume":"15","author":"Bhalla A","year":"2014","journal-title":"JOP"},{"key":"b53","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.18.5546"},{"key":"b54","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29041"},{"key":"b55","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.6228"},{"key":"b56","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji141"},{"key":"b57","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2009.073429"},{"key":"b58","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0215(20000915)87:6<809::AID-IJC8>3.0.CO;2-U"},{"key":"b59","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10159"},{"key":"b60","doi-asserted-by":"publisher","DOI":"10.1002\/pon.2080"},{"key":"b61","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-08-0403"},{"key":"b62","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2010.198"},{"key":"b63","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-007-9166-4"},{"key":"b64","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2000.20228"},{"key":"b65","volume-title":"Physician Fee Schedule Search","author":"US Centers for Medicare &amp; Medicaid Services","year":"2019"},{"key":"b66","volume-title":"Addendum B Hospital Outpatient Prospective Payment System","author":"US Centers for Medicare &amp; Medicaid Services","year":"2019"},{"key":"b67","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.18.19885"},{"key":"b68","volume-title":"Final Rule and Correction Notice Tables. Hospital Acute Inpatient Prospective Payment System","author":"US Centers for Medicare &amp; Medicaid Services","year":"2019"},{"key":"b69","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-1534"},{"key":"b70","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-40618-3"},{"key":"b71","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.12195"},{"key":"b72","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06290497"},{"key":"b73","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200006000-00014"},{"key":"b74","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-010-0883-8"},{"key":"b75","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001507"},{"key":"b76","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2011.09.001"},{"key":"b77","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.02.032"},{"key":"b78","doi-asserted-by":"publisher","DOI":"10.1177\/23814683211061097"},{"key":"b79","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2014.11.017"},{"key":"b80","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001268"},{"key":"b81","doi-asserted-by":"publisher","DOI":"10.1159\/000108969"},{"key":"b82","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002962"},{"key":"b83","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002422"}],"container-title":["JCO Oncology Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/OP.23.00495","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T18:01:38Z","timestamp":1707847298000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/OP.23.00495"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":83,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1200\/OP.23.00495"],"URL":"https:\/\/doi.org\/10.1200\/op.23.00495","relation":{},"ISSN":["2688-1527","2688-1535"],"issn-type":[{"value":"2688-1527","type":"print"},{"value":"2688-1535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]},"assertion":[{"value":"2023-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-05","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}