Probability that a CRC patient:
| |
Satisfies selection criteria | Dutch Cancer Registration |
Has a positive MSI test result (given selection criteria) | AZG |
Has a DNA mutation (given MSI positive and given selection criteria) | AZG |
Satisfies AC (given selection criteria and given MSI test negative) | AZG |
Has a DNA mutation (given the selection criteria and given a negative MSI test and given AC criteria) | AZG, Literature20–28 |
Has a positive family history | Literature11 |
That the family history is taken by medical specialist | UMCN |
Satisfies AC (given a positive family history) | UMCN |
Has a DNA mutation (given a positive family history and given AC) | UMCN |
Has a positive MSI test result (given a positive family history and not satisfying AC) | UMCN |
Has a DNA mutation (given a positive family history and not satisfying AC and given a positive MSI test result) | UMCN, AZG, Literature20–28 |
Probabilities that a first degree family member of a CRC patient:
| |
Satisfies the AC or has a CRC family member with positive DNA test result according to the new strategy | Patient model |
Satisfies the AC or has a CRC family member with positive DNA test result according to the current strategy | Patient model |
Is tested because the CRC family member has a positive DNA test result | Patient model |
Satisfies the AC without a verified detected mutation in the CRC family member, has an MLH1 or MSH2 mutation | Literature21,36,40 |
Has an MLH1 or MSH2 mutation (given the mutation in the CRC patient) | Literature11 |
Has an MLH1 or MSH2 mutation (not satisfying the AC and without a detected mutation in the CRC family member) | Expert opinion |
Probability that:
| |
A negative DNA test result is a true negative result | Literature21,36,40; expert opinion |
A negative MSI test result is a true negative result | Meta-analysis29 |
Not satisfying AC is true negative | Literature29 |
Costs
| |
MSI, DNA, counselling by a clinical geneticist, colonoscopy, subtotal colectomy | UMCN |
Follow up of an HNPCC patient | Patient records |