Table 3.
Model outcomes for costs, life-years, and quality-adjusted life-years (QALYs), undiscounted and discounted
| Population screening | Undiscounted | Discounted | |||||
|---|---|---|---|---|---|---|---|
| Probability | Cost, £ | Life-years | QALYs | Cost, £ | Life-years | QALYs | |
| A. PS, carrier, RRM, RRSO, no OC/BC | 0.0068 | 5197 | 53.00 | 53.00 | 3819 | 23.40 | 23.40 |
| B. PS, carrier, RRM, RRSO, OC | 0.0001 | 30 343 | 38.20 | 37.22 | 13550 | 19.75 | 19.39 |
| C. PS, carrier, RRM, RRSO, BC | 0.0002 | 27 936 | 46.92 | 45.63 | 28013 | 21.48 | 20.74 |
| D. PS, carrier, RRM, no RRSO, no OC/BC | 0.0038 | 2976 | 53.00 | 53.00 | 2766 | 23.40 | 23.40 |
| E. PS, carrier, RRM, no RRSO, OC | 0.0017 | 28 121 | 38.20 | 37.22 | 12497 | 19.75 | 19.39 |
| F. PS, carrier, RRM, no RRSO, BC | 0.0003 | 25 715 | 46.92 | 45.63 | 26960 | 21.48 | 20.74 |
| G. PS, carrier, no RRM, RRSO, no OC/BC | 0.0047 | 8297 | 53.00 | 53.00 | 5025 | 23.40 | 23.40 |
| H. PS, carrier, no RRM, RRSO, OC | 0.0001 | 33 442 | 38.20 | 37.22 | 16256 | 19.75 | 19.39 |
| I. PS, carrier, no RRM, RRSO, BC | 0.0017 | 31 036 | 46.92 | 45.63 | 29219 | 21.48 | 20.74 |
| J. PS, carrier, no RRM, no RRSO, no OC/BC | 0.0009 | 6075 | 53.00 | 53.00 | 3972 | 23.40 | 23.40 |
| K. PS, carrier, no RRM, no RRSO, OC | 0.0016 | 31 221 | 38.20 | 37.22 | 13703 | 19.75 | 19.39 |
| L. PS, carrier, no RRM, no RRSO, BC | 0.0028 | 28 814 | 46.92 | 45.63 | 28166 | 21.48 | 20.74 |
| M. PS, noncarrier, no OC/BC | 0.8355 | 423 | 53.00 | 53.00 | 213 | 23.40 | 23.40 |
| N. PS, noncarrier, OC | 0.0181 | 25 568 | 38.63 | 37.83 | 9274 | 19.99 | 19.72 |
| O. PS, noncarrier, BC | 0.1219 | 24 616 | 49.16 | 47.87 | 8868 | 22.50 | 22.05 |
| Family history screening | 1.0000 | ||||||
| P. FH pos, carrier, RRM, RRSO, no OC/BC | 0.0032 | 5197 | 53.0000 | 53.0000 | 3819 | 23.3988 | 23.3988 |
| Q. FH pos, carrier, RRM, RRSO, OC | 0.00004 | 30 343 | 38.2031 | 37.2150 | 13550 | 19.7536 | 19.3902 |
| R. FH pos, carrier, RRM, RRSO, BC | 0.0001 | 27 936 | 46.9236 | 45.6273 | 28013 | 21.4791 | 20.7432 |
| S. FH pos, carrier, RRM, no RRSO, no OC/BC | 0.0018 | 2976 | 53.0000 | 53.0000 | 2766 | 23.3988 | 23.3988 |
| T. FH pos, carrier, RRM, no RRSO, OC | 0.0008 | 28 121 | 38.2031 | 37.2150 | 12497 | 19.7536 | 19.3902 |
| U. FH pos, carrier, RRM, no RRSO, BC | 0.0001 | 25 715 | 46.9236 | 45.6273 | 26960 | 21.4791 | 20.7432 |
| V. FH pos, carrier, no RRM, RRSO, no OC/BC | 0.0022 | 8297 | 53.0000 | 53.0000 | 5025 | 23.3988 | 23.3988 |
| W. FH pos, carrier, no RRM, RRSO, OC | 0.0000 | 33 442 | 38.2031 | 37.2150 | 14756 | 19.7536 | 19.3902 |
| X. FH pos, carrier, no RRM, RRSO, BC | 0.0008 | 31 036 | 46.9236 | 45.6273 | 29219 | 21.4791 | 20.7432 |
| Y. FH pos, carrier, no RRM, no RRSO, no OC/BC | 0.0004 | 6075 | 53.0000 | 53.0000 | 3972 | 23.3988 | 23.3988 |
| Z. FH pos, carrier, no RRM, no RRSO, OC | 0.0007 | 31 221 | 38.2031 | 37.2150 | 13703 | 19.7536 | 19.3902 |
| AA. FH pos, carrier, no RRM, no RRSO, BC | 0.0013 | 28 814 | 46.9236 | 45.6273 | 28166 | 21.4791 | 20.7432 |
| AB. FH pos, noncarrier, no OC/BC | 0.0961 | 423 | 53.0000 | 53.0000 | 213 | 23.3988 | 23.3988 |
| AC. FH pos, noncarrier, OC | 0.0021 | 25 568 | 38.6324 | 37.8321 | 9274 | 19.9915 | 19.7169 |
| AD. FH pos, noncarrier, BC | 0.0140 | 24 616 | 49.1623 | 47.8660 | 8868 | 22.4951 | 22.0482 |
| AE. FH neg, carrier, no OC/BC | 0.0030 | 330 | 53.0000 | 53.0000 | 120 | 23.3988 | 23.3988 |
| AF. FH neg, carrier, OC | 0.0053 | 25 475 | 38.2031 | 37.2150 | 9851 | 19.7536 | 19.3902 |
| AG. FH neg, carrier, BC | 0.0095 | 23 069 | 46.9236 | 45.6273 | 24314 | 21.4791 | 20.7432 |
| AH. FH neg, noncarrier, no OC/BC | 0.7352 | 330 | 53.0000 | 53.0000 | 120 | 23.3988 | 23.3988 |
| AI. FH neg, noncarrier, OC | 0.0159 | 25 475 | 38.6324 | 37.8321 | 9182 | 19.9915 | 19.7169 |
| AJ. FH neg, noncarrier, BC | 0.1073 | 24 524 | 49.1623 | 47.8660 | 8775 | 22.4951 | 22.0482 |
| Average population screening | 0.1484* | 4156 | 52.1912 | 52.0088 | 1677 | 23.2049 | 23.1406 |
| Average family history screening | 0.1587* | 4233 | 52.1016 | 51.9078 | 1741 | 23.1799 | 23.1096 |
| Incremental (difference) | -0.0096 | -77 | 0.090 | 0.101 | -64 | 0.025 | 0.031 |
| Cost per quality-adjusted life-year | -767 | -2079 | |||||
| Total population screening effect | 837† | -4467529 | 5166 | 5827 | -3718526 | 1442 | 1789 |
| Jewish population screened | 81 224 | ||||||
* Cancer incidence. BC = breast cancer; FH = family history; neg = negative; OC = ovarian cancer; pos = positive; PS = population screening; QALY = quality-adjusted life-year; RRSO = risk-reducing salpingo-oophorectomy, RRM = risk-reducing mastectomy.
† Reduction in total number of cancer cases.