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

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2011
Author
Carles Lavila, Misericordia
Vilaprinyo Terré, Ester
Cots, Francesc
Gregori Gomis, Aleix
Pla Farnós, Roger
Román, Rubén
Sala i Serra, Maria
Macià, Francesc
Castells, Xavier
Rué i Monné, Montserrat
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Carles Lavila, Misericordia; Vilaprinyo Terré, Ester; Cots, Francesc; Gregori Gomis, Aleix; Pla Farnós, Roger; Román, Rubén; ... Rué i Monné, Montserrat. (2011) . Cost-effectiveness of early detection of breast cancer in Catalonia (Spain). BMC Cancer, 2011, vol. 11, núm. 192, p. 1-11. https://doi.org/10.1186/1471-2407-11-192.
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Abstract
Background: Breast 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. Methods: We 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. Results: Strategies 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. Conclusions: A 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.
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http://hdl.handle.net/10459.1/41532
DOI
https://doi.org/10.1186/1471-2407-11-192
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BMC Cancer, 2011, vol. 11, núm. 192, p. 1-11
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Except where otherwise noted, this item's license is described as cc-by, (c) Carles et al., 2011