Ductal carcinomas in situ and invasive cancers detected on screening mammography: Cost-effectiveness of initial and subsequent rounds of population-based program 2007-2014

Abstract

Background. Potential benefits of screening need to be carefully balanced against the financial burden for the national health care system. Objectives. To assess the cost-effectiveness of population-based mammographic screening in the 3-million region of Lower Silesia (Poland) after initial and 3 subsequent rounds. Material and methods. Data was collected in a prospective manner using the databases of the official computer system for the monitoring of prophylaxis programs (SIMP), National Health Fund (Lower Silesia Regional Branch) and the Lower Silesia Cancer Registry. The expenses from each analyzed year were obtained from the Regional Coordinating Center for Screening Programs. The number of screen-detected and pathologically proven invasive and ductal in situ cancers was calculated. Costs of cancer detection were measured, converted into US dollars (USD), and expressed in 2015 USD using the comparison of purchasing power of money calculated with the Consumer Price Index. Results. The total expense for the screening program in the initial round (2007-2008), first (2009-2010), second (2011-2012) and third (2013-2014) subsequent rounds was 4 732 383, 6 043 509, 6 484 834, and 5 900 793 USD whereas the number of cancer detected was 1049, 987, 1312, and 1070. The costeffectiveness ratio obtained in the program for each year was 4511, 6123, 4943, and 5515 USD per cancer found. The average cost of breast cancer detection in screening program in the region of Lower Silesia in years 2007-2014 was 5243 USD. Conclusions. The low cost of breast cancer detection in mammographic screening program makes it applicable for the health care systems in emerging economies.