{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:49:04Z","timestamp":1787503744708,"version":"build-2736575974"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The women\u2019s cancer screening program has been operational for several years in China, primarily utilizing palpation and ultrasound. Given the proven impact of\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      mutations on the incidence of breast and ovarian cancer, the cost-effectiveness of incorporating\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      mutation testing into these programs, either for the entire population or through enrichment based on family history of breast and ovarian cancer, remains poorly researched.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We constructed a decision tree model to compare the cost-effectiveness of three strategies: symptom-based screening only (Symptom-only strategy), population-based\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      testing (population-based strategy), and family-history-based\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      testing (FH-based strategy). One-way and probability sensitivity analyses enabled model uncertainty evaluation. Outcomes included early and advanced stages of ovarian and breast cancer. Cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated. The target population was women at 40\u201360\u202fyears, the time horizon was until age 70, and the perspective was payer-based.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The FH-based strategy was found to be cost-effective compared to the Symptom-only strategy (ICER: \u00a5185,710\/QALY, gaining 0.26\u202fdays\u2019 life expectancy). Its cost-effectiveness was significantly influenced by the risks of ovarian and breast cancer among\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      carriers, the prevalence of\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      mutations in the general Chinese population, the prevalence of family history of breast and ovarian cancer among Chinese women, and the prevalence of\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      mutations in the FH-positive population. Integrating these variable distributions, the FH-based strategy showed a 76.96% probability of cost-effectiveness. The Population-based strategy was not cost-effective, whether compared to the Symptom-only strategy (ICER: \u00a5504,476\/QALY, gaining 2.66\u202fdays\u2019 life expectancy) or to the FH-based strategy (ICER: \u00a5539,476\/QALY, gaining 2.41\u202fdays\u2019 life expectancy). The prevalence of\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      mutations in the general Chinese population was identified as the primary variable affecting its cost-effectiveness. Integrating these variable distributions, the Population-based strategy had a probability of cost-effectiveness of only 0.8%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Incorporating family-history-based\n                      <jats:italic>BRCA1\/2<\/jats:italic>\n                      testing into breast and ovarian cancer screening programs is cost-effective in China and warrants promotion.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1479966","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T01:15:08Z","timestamp":1749604508000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Cost-effectiveness analysis of population-based BRCA1\/2 testing, family-history-based BRCA1\/2 testing, and symptom-based screening for breast and ovarian cancer in China"],"prefix":"10.3389","volume":"13","author":[{"given":"Feilong","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfei","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangying","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwei","family":"Ran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"221","DOI":"10.3760\/cma.j.cn112152-20240119-00035","article-title":"Cancer 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