Evidence map›Paper›PMID 42552405›Full record

Observational studyInternational journal of clinical oncology2026

Clinical utility and cost-effectiveness of universal tumor screening to identify Lynch syndrome in patients with stage II/III colorectal cancer: a prospective observational study in Japan.

Takahiro Yoshioka, Yasuaki Yamamoto, Yuichiro Tsukada, Ataru Igarashi, Takeshi Kuwata, Motohiro Kojima, Yumie Hiraoka, Koji Ikeda, Yuji Nishizawa, Hideaki Bando and 3 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Takahiro YoshiokaDepartment of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Yasuaki YamamotoDepartment of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Yuichiro TsukadaDepartment of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. yutsukad@east.ncc.go.jp.
Ataru IgarashiUnit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Yokohama, Japan.
Takeshi KuwataDepartment of Genetic Medicine and Services, National Cancer Center Hospital East, Chiba, Japan.
Motohiro KojimaDivision of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Chiba, Japan.
Yumie HiraokaDepartment of Genetic Medicine and Services, National Cancer Center Hospital East, Chiba, Japan.
Koji IkedaDepartment of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Yuji NishizawaDepartment of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Hideaki BandoDepartment of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan.
Kiwamu AkagiDepartment of Genetic Medicine and Services, National Cancer Center Hospital East, Chiba, Japan.
Takayuki YoshinoDepartment of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan.
Masaaki ItoDepartment of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUniversal tumor screening (UTS) for Lynch syndrome (LS) is cost-effective in Western countries; however, cost-effectiveness varies based on the frequency of hereditary diseases and testing costs. This study aimed to clarify the clinical utility and cost-effectiveness of UTS in identifying LS in patients with stage II/III colorectal cancer (CRC) in Japan.

methodsThis single-center, prospective cohort study evaluated 591 consecutive patients who underwent surgical resection for Stage II/III colorectal adenocarcinoma between 2016 and 2018. Immunohistochemistry (IHC) was used to evaluate mismatch repair (MMR) proteins. In patients with MMR deficiency, BRAF V600E mutational testing and genetic counseling/testing were performed to identify LS based on MMR deficiency patterns. Genetic counseling/testing was also conducted for blood relatives upon request. The cost-effectiveness of implementing UTS was evaluated from the perspective of healthcare payers using a Markov state-transition model, with the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) gained as the reference value.

resultsA total of 40 cases (6.8%) exhibited MMR deficiency; 12 cases (2.0%) had LS, of whom 2 (16.7%) did not meet Amsterdam criteria II or any criteria of the revised Bethesda guidelines. Eleven relatives of five LS probands underwent genetic testing, and six (54.5%) were diagnosed with LS. The ICER for UTS was JPY 0.6 million per QALY gained, substantially below the Japanese threshold of JPY 5.0-6.0 million per QALY.

conclusionsThe UTS of LS in patients with stage II/III CRC is a useful and cost-effective tool in Japan.

Indexed as

Colorectal NeoplasmsColorectal Neoplasms, Hereditary NonpolyposisEarly Detection of CancerAdultAgedCost-Benefit AnalysisCost-Effectiveness AnalysisDNA Mismatch RepairFemaleGenetic TestingHumansJapanMaleMiddle AgedNeoplasm StagingProspective StudiesBRAF protein, humanProto-Oncogene Proteins B-rafClinical utilityColorectal cancerCost-effectivenessLynch syndromeUniversal tumor screening

Identifiers

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.