Economic evaluation of photodynamic diagnosis

Systematic review of the clinical and cost-effectiveness, and economic evaluation, of photodynamic diagnosis and novel urine biomarker tests in the detection and follow-up of bladder cancer

Bladder cancer is a common cancer in the UK affecting more than 10,000 individuals each year. Cystoscopy is the gold standard test for diagnosing cancer of the bladder, but it does not provide complete detection of cancerous lesions. Cystoscopy with biopsy is currently used to diagnose bladder cancer and repeated operative follow up is advised. Photodynamic diagnosis can be used to enhance cystoscopy during initial diagnosis and staging of bladder cancer, or as part of follow-up evaluation. Novel urine biomarker tests may also be used, both in diagnosis (or its exclusion) and in follow up so that people who have had bladder cancer will not have repeated cystoscopies.

Outcome and Translation

The results indicated that strategies involving biomarkers and or photodynamic diagnosis provide additional benefits at a cost society might be willing to pay. Further research is needed to compare photodynamic diagnosis with rigid white light cystoscopy at trans urethral resection of bladder tumour plus adjuvant immediate single-dose intravesical chemotherapy in patients diagnosed with bladder tumours at flexible cystoscopy.

HERU researchers involved in this research project: Mary Kilonzo and Luke Vale (HERU/HSRU)

External Collaborators: G Mowatt, S Zhu, C Fraser (HSRU, University of Aberdeen); J N’Dow, G Nabi, S Swami and A Grant (University of Aberdeen)

Publications

Mowatt, G., Zhu, Z., Kilonzo, M., Boachie, C., Fraser, C., Griffiths, T.R.L., N'Dow, J., Nabi, G., Cook, J. and Vale, L. (2008) Systematic review of the clinical and cost-effectiveness of photodynamic diagnosis and urine biomarkers. (FISH, ImmunoCyt NMP22) and cytology for the detection and follow-up of bladder cancer. Final report to the NHS HTA Programme.

Glazener, C., Boachie, C., Buckley, B., Cochran, C., Dorey, G., Grant, A., Hagen, S., Kilonzo, M., McDonald, A., McPherson, G., Moore, K., N’Dow, J., Ramsay, C. and Vale, L. (2010) Conservative treatment for urinary incontinence in men after prostate surgery (MAPS). Final report submitted to NIHR Health Technology Assessment Programme, National Institute for Health Research.

Kilonzo, M. and Vale, L. (2010) 'Economic evaluation of urinary biomarkers and cystoscopy with photodynamic diagnosis and for detection and follow-up of bladder cancer', HERU Briefing Paper, University of Aberdeen, April 2010.

Mowatt, G., Zhu, S., Kilonzo, M., Boachie, C., Fraser, C., Griffiths, T.R.L., N'Dow, J., Nabi, G., Cook, J. and Vale, L. (2010) 'Systematic review of the clinical effectiveness and cost-effectiveness of photodynamic diagnosis and urine biomarkers (FISH, ImmunoCyt, NMP22) and cytology for the detection and follow-up of bladder cancer', Health Technology Assessment, 14(4).

Presentations

Kilonzo, M. (2009) ‘Economic evaluation of photodynamic diagnosis and urinary biomarkers for detection and follow-up of bladder cancer’, British Association of Urological Surgeons, Glasgow, 2009.

Kilonzo, M., Vale, L., Zhu, S., Mowatt, G., Boachie, C., N'Dow, J., Griffiths, T. R. L., Cook, J., Nabi, G. and Fraser, C. (2010) 'Economic evaluation of photodynamic diagnosis and urinary biomarkers for detection and follow-up of bladder cancer', 7th Annual Health Technology Assessment International, Dublin, June 2010.

Mowatt, G., N'Dow, J., Zhu, S., Kilonzo, M., Boachie, C., Fraser, C., Nabi, G., Cook, J., Vale, L. and Griffiths, T. R. L. (2010) 'Systematic review and meta-analysis of photodynamic diagnosis of bladder cancer compared with white light cytoscopy', 7th Annual Health Technology Assessment international (HTAi), Dublin, June 2010.