[The study of cost effectiveness of breast cancer detection in Catalonia]. / Estudio del coste-efectividad de un programa de detección precoz del cáncer de mama en Cataluña.

BACKGROUND: This study has researched the cost-effectiveness of Early Diagnosis of Breast Cancer in Catalonian women in the 50-64 age group. METHODS: The cost-effectiveness ratio was obtained by comparing the costs of a program for 100,000 women with results achieved. The program consisted of a twice yearly mammography on all of the women over a 10 year period. The study assumed a participation level of 70%, detection rate of 0.36%, 92% sensitivity and specificity of 94%. RESULTS: A cost-effectiveness ratio of 1,413.648 pesetas was determined per case of cancer detected. 705,489 per year of extended life and 783,982 per year of extended life adjusted according to quality. Cost-effectiveness of the test in the first year was 842,400 per case of cancer detected. 383,183 per year of extended life and 425,418 per year of extended life adjusted according to quality. CONCLUSION: The results of the study are consistent with those obtained by other evaluations and show that early diagnosis of breast cancer is associated with a favourable cost-effectiveness ratio.

Cost-effectiveness of breast cancer screening in Spain.

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.