Melanoma burden by melanoma stage: Assessment through a disease transition model

Tromme, Isabelle; Legrand, Catherine; Devleesschauwer, Brecht; Leiter, Ulrike; Suciu, Stefan; Eggermont, Alexander M.M.; Francart, Julie; Calay, F.; Haagsma, Juanita A.; Baurain, Jean‐François; Thomas, Luc; Beutels, Philippe; Speybroeck, Niko

doi:10.1016/j.ejca.2015.09.016

Cited by 21 publications

(32 citation statements)

References 27 publications

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“…The TPs were based on the data presented in Leiter et al [11], Eggermont et al [12] and Maio et al [13]. For this CEA, contrary to the MDM presented previously [2], we consider that patients can die from any cause at any age (versus only at the end of life expectancy in the previous analysis). These TPs to death from other causes were derived from Belgian mortality tables and are gender-and age dependent [14].…”

Section: Introductionmentioning

confidence: 99%

“…Models are therefore used to simulate the future of patient cohorts. We recently built such a model, further referred to as the 'melanoma disease model' (MDM), to assess the evolution of melanoma patient cohorts and calculate the melanoma burden in terms of localised, node and distant metastatic stages [2].…”

Section: Introductionmentioning

confidence: 99%

“…Fig. 1 shows the MDM previously described in details [2]. In brief, melanoma patients were set to start at one of the diagnostic stages and entered into the model for a certain number of 1-year cycles, until death.…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness analysis in melanoma detection: A transition model applied to dermoscopy

Tromme

Legrand

Devleesschauwer

et al. 2016

European Journal of Cancer

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Aim: The main aim of this study is to demonstrate how our melanoma disease model (MDM) can be used for cost-effectiveness analyses (CEAs) in the melanoma detection field. In particular, we used the data of two cohorts of Belgian melanoma patients to investigate the cost-effectiveness of dermoscopy. Methods: A MDM, previously constructed to calculate the melanoma burden, was slightly modified to be suitable for CEAs. Two cohorts of patients entered into the model to calculate morbidity, mortality and costs. These cohorts were constituted by melanoma patients diagnosed by dermatologists adequately, or not adequately, trained in dermoscopy. Effectiveness and costs were calculated for each cohort and compared. Effectiveness was expressed in (2016) 38e45 quality-adjusted life years (QALYs), a composite measure depending on melanoma-related morbidity and mortality. Costs included costs of treatment and follow-up as well as costs of detection in non-melanoma patients and costs of excision and pathology of benign lesions excised to rule out melanoma. Results: The result of our analysis concluded that melanoma diagnosis by dermatologists adequately trained in dermoscopy resulted in both a gain of QALYs (less morbidity and/or mortality) and a reduction in costs. Conclusion: This study demonstrates how our MDM can be used in CEAs in the melanoma detection field. The model and the methodology suggested in this paper were applied to two cohorts of Belgian melanoma patients. Their analysis concluded that adequate dermoscopy training is cost-effective. The results should be confirmed by a large-scale randomised study. ª

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness analysis in melanoma detection: A transition model applied to dermoscopy

Tromme

Legrand

Devleesschauwer

et al. 2016

European Journal of Cancer

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“…Pooling GBD data across countries may allow identification of groups within a population who have the highest burden of disease. For example, compared with other cancers affecting adults, melanoma has a large burden of disease in terms of years of life lost due to its relatively low mean age at diagnosis . However, people aged 70 years and older carry the greatest burden from melanoma out of any age group, as incidence rates rise with age due to the cumulative effects of sun exposure and other risk factors over a lifetime …”

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confidence: 99%

“…For example, compared with other cancers affecting adults, melanoma has a large burden of disease in terms of years of life lost due to its relatively low mean age at diagnosis. 5,6 However, people aged 70 years and older carry the greatest burden from melanoma out of any age group, as incidence rates rise with age due to the cumulative effects of sun exposure and other risk factors over a lifetime. 1 Comparing GBD data between countries may be used to evaluate potential effects of differences in public policies and highlight where these may be deficient.…”

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confidence: 99%

Beyond country-specific incidence and mortality: the global burden of melanoma

Bell

Cust

2018

Br J Dermatol

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Health Economic Consequences Associated With COVID-19–Related Delay in Melanoma Diagnosis in Europe

Maul,

Jamiolkowski,

Lapides

et al. 2024

JAMA Netw Open

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ImportanceThe COVID-19 pandemic resulted in delayed access to medical care. Restrictions to health care specialists, staff shortages, and fear of SARS-CoV-2 infection led to interruptions in routine care, such as early melanoma detection; however, premature mortality and economic burden associated with this postponement have not been studied yet.ObjectiveTo determine the premature mortality and economic costs associated with suspended melanoma screenings during COVID-19 pandemic lockdowns by estimating the total burden of delayed melanoma diagnoses for Europe.Design, Setting, and ParticipantsThis multicenter economic evaluation used population-based data from patients aged at least 18 years with invasive primary cutaneous melanomas stages I to IV according to the American Joint Committee on Cancer (AJCC) seventh and eighth editions, including melanomas of unknown primary (T0). Data were collected from January 2017 to December 2021 in Switzerland and from January 2019 to December 2021 in Hungary. Data were used to develop an estimation of melanoma upstaging rates in AJCC stages, which was verified with peripandemic data. Years of life lost (YLL) were calculated and were, together with cost data, used for financial estimations. The total financial burden was assessed through direct and indirect treatment costs. Models were building using data from 50 072 patients aged 18 years and older with invasive primary cutaneous melanomas stages I to IV according to the AJCC seventh and eighth edition, including melanomas of unknown primary (T0) from 2 European tertiary centers. Data from European cancer registries included patient-based direct and indirect cost data, country-level economic indicators, melanoma incidence, and population rates per country. Data were analyzed from July 2021 to September 2022.ExposureCOVID-19 lockdown-related delay of melanoma detection and consecutive public health and economic burden. As lockdown restrictions varied by country, lockdown scenario was defined as elimination of routine medical examinations and severely restricted access to follow-up examinations for at least 4 weeks.Main Outcomes and MeasuresPrimary outcomes were the total burden of a delay in melanoma diagnosis during COVID-19 lockdown periods, measured using the direct (in US$) and indirect (calculated as YLL plus years lost due to disability [YLD] and disability-adjusted life-years [DALYs]) costs for Europe. Secondary outcomes included estimation of upstaging rate, estimated YLD, YLL, and DALY for each European country, absolute direct and indirect treatment costs per European country, proportion of the relative direct and indirect treatment costs for the countries, and European health expenditure.ResultsThere were an estimated 111 464 (range, 52 454-295 051) YLL due to pandemic-associated delay in melanoma diagnosis in Europe, and estimated total additional costs were $7.65 (range, $3.60 to $20.25) billion. Indirect treatment costs were the main cost driver, accounting for 94.5% of total costs. Estimates for YLD in Europe resulted in 15 360 years for the 17% upstaging model, ranging from 7228 years (8% upstaging model) to 40 660 years (45% upstaging model). Together, YLL and YLD constitute the overall disease burden, ranging from 59 682 DALYs (8% upstaging model) to 335 711 DALYs (45% upstaging model), with 126 824 DALYs for the real-world 17% scenario.Conclusions and RelevanceThis economic analysis emphasizes the importance of continuing secondary skin cancer prevention measures during pandemics. Beyond the personal outcomes of a delayed melanoma diagnosis, the additional economic and public health consequences are underscored, emphasizing the need to include indirect economic costs in future decision-making processes. These estimates on DALYs and the associated financial losses complement previous studies highlighting the cost-effectiveness of screening for melanoma.

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Melanoma burden by melanoma stage: Assessment through a disease transition model

Cited by 21 publications

References 27 publications

Cost-effectiveness analysis in melanoma detection: A transition model applied to dermoscopy

Cost-effectiveness analysis in melanoma detection: A transition model applied to dermoscopy

Beyond country-specific incidence and mortality: the global burden of melanoma

Health Economic Consequences Associated With COVID-19–Related Delay in Melanoma Diagnosis in Europe

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