Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-29T13:28:31.454Z Has data issue: false hasContentIssue false

Cost-Effectiveness of Breast Cancer Screening in Spain

Published online by Cambridge University Press:  10 March 2009

Pedro Plans
Affiliation:
Department of Health, Catalunya
Laura Casademont
Affiliation:
Laboratorio Echevarne
Luis Salleras
Affiliation:
Department of Health, Catalunya

Abstract

In the last several years, the development of an effective breast cancer screening procedure has increased the possibility of the early detection of this cancer. We investigated the cost-effectiveness of a breast cancer screening program to screen 100,000 women 50–64 years of age in Catalonia (Spain). The cost-effectiveness ratio was measured in terms of the cost per cancer detected comparing program costs to the estimated number of cancers detected. We assumed a participation rate, sensitivity, and specificity of 70%, 92%, and 94%, respectively, and that 0.36 breast cancers could be detected per 100 women screened. We estimated a total cost of $2.1 million with $1.4 million for the mammographic stage and $0.7 million for the detection of the true positive mammographic results. The cost per woman screened was $30. We estimated that 252 cases of breast cancer could be detected with the program. The cost-effectiveness ratio obtained in this study was $8,424 per cancer detected. Sensitivity analysis has shown that cost-effectiveness results are sensitive to the variations in the following variables: specificity, cancer detection rate, and screening costs. In planning preventive programs, breast cancer screening should be considered one of the priorities.

Type
Research Notes
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Parkin, , Muir, , Whelan, , Gao, , Ferlay, , & Powell, (eds.). Cancer incidence in five continents, vol. 6. Lyon: IARC Scientific Publications, 1992, No. 120.Google Scholar
2.Cockburn, J., Staples, M., Hurley, S. F., & De Luise, T.Psychological consequences of screening mammography. Journal of Medical Screening, 1994, 1, 712.Google Scholar
3.Departament de Sanitat. Pla de Salut de Catalunya. Barcelona: Departament de Sanitat, 1993.Google Scholar
4.Eddy, D. M.Screening for breast cancer. Annals of Internal Medicine, 1989, 111, 389–99.Google Scholar
5.Gad, A., Thomas, B. A., & Moskowitz, M.Screening for breast cancer in Europe: Achievements, problems and the future. Recent Results of Cancer Research, 1984, 90, 179–94.Google Scholar
6.Gravelle, H. S. E., Simpson, P. R., & Chamberlain, J.Breast cancer screening and health services costs. Journal of Health Economics, 1982, 1, 185207.CrossRefGoogle Scholar
7.Koning, H. J., Ineveld, B. M., Oortmarssen, G. J. et al. Breast cancer screening and cost-effectiveness: Policy alternatives, quality of life considerations and the possible impact of uncertain factors. International Journal of Cancer, 1991, 49, 531–37.CrossRefGoogle ScholarPubMed
8.Miller, A. B., Howe, G. R., & Wall, C.The national study of breast cancer screening. Clinical Investigative Medicine, 1982, 4, 227–58.Google Scholar
9.Roberts, M. M., Alexander, F. E., Anderson, T. J. et al. Edinburgh trial of screening for breast cancer: Mortality at seven years. Lancet, 1990, 335, 241–46.Google Scholar
10.Tabar, L., Gat, A., Holmberg, L. H. et al. Reduction in mortality from breast cancer after mass screening with mammography. Lancet, 1985, 1, 829–32.CrossRefGoogle ScholarPubMed
11.UK Trial of Early Detection of Breast Cancer Group. First results on mortality reduction in the UK trial of early detection of breast cancer. Lancet, 1988, 2, 411–16.Google Scholar
12.UK Trial of Early Detection of Breast Cancer Group. Specificity of screening in United Kingdom trial of early detection of breast cancer. British Medical Journal, 1992, 304, 246349.Google Scholar
13.Verbeek, A. L. M., Hendricks, J. H. O. L., Holland, R. et al. Reduction in breast cancer mortality through mass screening with modern mammography. Lancet, 1984, 1, 1222–24.Google Scholar
14.WHO. World statistic annual, 1993. Geneva: WHO, 1994.Google Scholar