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A modelling study to evaluate the costs and effects of lowering the starting age of population breast cancer screening.
- Source :
-
Maturitas [Maturitas] 2018 Mar; Vol. 109, pp. 81-88. Date of Electronic Publication: 2017 Dec 15. - Publication Year :
- 2018
-
Abstract
- Background: Because the incidence of breast cancer increases between 45 and 50years of age, a reconsideration is required of the current starting age (typically 50years) for routine mammography. Our aim was to evaluate the quantitative benefits, harms, and cost-effectiveness of lowering the starting age of breast cancer screening in the Dutch general population.<br />Methods: Economic modelling with a lifelong perspective compared biennial screening for women aged 48-74years and for women aged 46-74years with the current Dutch screening programme, which screen women between the ages of 50 and 74years. Tumour deaths prevented, years of life saved (YOLS), false-positive rates, radiation-induced tumours, costs and incremental cost-effectiveness ratios (ICERs) were evaluated.<br />Results: Starting the screening at 48 instead of 50 years of age led to increases in: the number of small tumours detected (4.0%), tumour deaths prevented (5.6%), false positives (9.2%), YOLS (5.6%), radiation-induced tumours (14.7%), and costs (4.1%). Starting the screening at 46 instead of 48 years of age increased the number of small tumours detected (3.3%), tumour deaths prevented (4.2%), false positives (8.8%), YOLS (3.7%), radiation-induced tumours (15.2%), and costs (4.0%). The ICER was €5600/YOLS for the 48-74 scenario and €5600/YOLS for the 46-74 scenario.<br />Conclusions: Women could benefit from lowering the starting age of screening as more breast cancer deaths would be averted. Starting regular breast cancer screening earlier is also cost-effective. As the number of additional expected harms is relatively small in both the scenarios examined, and the difference in ICERs is not large, introducing two additional screening rounds is justifiable.<br /> (Copyright © 2017 Elsevier B.V. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1873-4111
- Volume :
- 109
- Database :
- MEDLINE
- Journal :
- Maturitas
- Publication Type :
- Academic Journal
- Accession number :
- 29452787
- Full Text :
- https://doi.org/10.1016/j.maturitas.2017.12.009