Screening mammography beginning at age 40 years : A reappraisal of cost-effectiveness

• Published in: Cancer 1998-06, Vol.82 (11), p.2235-2240
• Main Authors: ROSENQUIST, C. J, LINDFORS, K. K
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Biological and medical sciences; Breast Neoplasms - diagnostic imaging; Cost-Benefit Analysis; Female; Gynecology. Andrology. Obstetrics; Humans; Mammary gland diseases; Mammography - economics; Medical sciences; Middle Aged; Tumors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19980601)82:11<2235::AID-CNCR19>3.0.CO;2-V

Several recent studies have added significant information regarding the benefit of screening mammography, especially in the 40-49-years age group. This new information makes it important to reassess the cost-effectiveness of screening. A Markov model was used to study the cost-effectiveness of 4 age-related screening strategies: 1) annually from ages 40-79 years; 2) annually from ages 40-64 years and biennially from ages 65-79 years; 3) annually from ages 40-49 years and biennially from ages 50-79 years; and 4) annually from ages 40-79 years in high risk women (10%) and biennially from ages 40-49 years followed by annually from ages 50 -79 years in normal risk women (90%). An additional strategy simulating hormone status and estrogen exposure was evaluated. Cost-effectiveness was expressed as marginal cost per year-life saved (MCYLS). The MCYLS varied from $18,800 to $16,100. For all strategies this was within the range of other generally acceptable diagnostic and therapeutic medical procedures. There was a 14% decrease in MCYLS from the least cost-effective to the most cost-effective strategy. Cost-effectiveness of four age-related mammographic screening strategies was evaluated. The MCYLS for all strategies was within a generally accepted range. With increasing concerns regarding the cost of health care, this information may be useful in health policy decision-making.