Cost-effectiveness of early detection of breast cancer in Catalonia (Spain)

BMC Cancer

Research Article

Montserrat Rue¹  Aleix Gregori²  Misericordia Carles²  Xavier Castells³  Maria Sala³  Francesc Cots³  Rubén Román³  Ester Vilaprinyo³  Francesc Macià³  Roger Pla⁴ 

[1] Basic Medical Sciences Department, Biomedical Research Institut of Lleida (IRBLLEIDA)-University of Lleida, Lleida, Catalonia, Spain;Economics Department, Rovira i Virgili University, Reus, Catalonia, Spain;Evaluation and Clinical Epidemiology Department, Parc de Salut Mar and CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Catalonia, Spain;Terres de l'Ebre Region, Catalan Institute of Health, Catalonia, Spain;

关键词: Breast Cancer;    Breast Cancer Screening;    Mammography Screening;    Screening Strategy;    Breast Cancer Mortality;   

DOI  :  10.1186/1471-2407-11-192

 received in 2010-10-26, accepted in 2011-05-23,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundBreast cancer (BC) causes more deaths than any other cancer among women in Catalonia. Early detection has contributed to the observed decline in BC mortality. However, there is debate on the optimal screening strategy. We performed an economic evaluation of 20 screening strategies taking into account the cost over time of screening and subsequent medical costs, including diagnostic confirmation, initial treatment, follow-up and advanced care.MethodsWe used a probabilistic model to estimate the effect and costs over time of each scenario. The effect was measured as years of life (YL), quality-adjusted life years (QALY), and lives extended (LE). Costs of screening and treatment were obtained from the Early Detection Program and hospital databases of the IMAS-Hospital del Mar in Barcelona. The incremental cost-effectiveness ratio (ICER) was used to compare the relative costs and outcomes of different scenarios.ResultsStrategies that start at ages 40 or 45 and end at 69 predominate when the effect is measured as YL or QALYs. Biennial strategies 50-69, 45-69 or annual 45-69, 40-69 and 40-74 were selected as cost-effective for both effect measures (YL or QALYs). The ICER increases considerably when moving from biennial to annual scenarios. Moving from no screening to biennial 50-69 years represented an ICER of 4,469€ per QALY.ConclusionsA reduced number of screening strategies have been selected for consideration by researchers, decision makers and policy planners. Mathematical models are useful to assess the impact and costs of BC screening in a specific geographical area.

【 授权许可】

Unknown   
© Carles et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.