Is liquid biopsy a cost-effective method to diagnose Burkitt Lymphoma in children and young adults? A health economic evaluation in Tanzania

作者：Jingjing Jiang, Liz Morrell, Malale Tungu, William Frank Mawalla, Clara Chamba, Lulu Chirande, Heronima Kashaigili, Elifuraha Mkwizu, Paul S. Ntemi, Godlove Sandi, Kristin Schroeder, Anna Schuh, George M. Ruhago, Sarah Wordsworth · 发表于：Figshare · 年份：2026 · DOI：10.6084/m9.figshare.c.8388351 · 研究领域：Medicine、Pediatrics、Intensive care medicine、Surgery

Abstract Background Burkitt Lymphoma (BL) is a prevalent and highly aggressive childhood cancer in sub-Saharan Africa (SSA). Outcomes are poor, due in part to delays or inaccuracies in diagnosis. Liquid biopsy (sequencing circulating tumour DNA from blood) is an alternative approach that is non-invasive and offers potential for a highly specific, rapid diagnosis, which could improve outcomes through earlier access to correct treatment. Diagnosis by liquid biopsy has undergone validation in SSA. However, evidence on its economic value is needed, especially in limited-resource settings. We present a cost-utility analysis comparing liquid biopsy with conventional local histopathology for the diagnosis of paediatric BL in Tanzania. Methods A cost-utility model was constructed to compare the costs and effects of the alternative diagnostic approaches from a Tanzanian healthcare provider perspective, over a lifetime horizon. For the liquid biopsy, we assumed testing at the patient’s first contact with healthcare, resulting in earlier diagnosis. Resource use and outcome data were taken from the Aggressive Infection-Related East Africa Lymphoma study. Health outcomes were measured in Disability-Adjusted Life Years (DALYs). Costs and outcomes were discounted at 5%. Probabilistic and univariate sensitivity analyses and scenario analysis were conducted. Results Diagnosis by liquid biopsy results in a reduced burden of 9.4 DALYs per patient compared to 10.5 for histopathology (difference ...