Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-15T14:25:42.059Z Has data issue: false hasContentIssue false
  • English
  • Français

Costs of Breast Cancer and the Cost-Effectiveness of Breast Cancer Screening

Published online by Cambridge University Press:  10 March 2009

Anne Elixhauser
Anne Elixhauser
Affiliation:
U.S. Agency for Health Care Policy and Research
Get access Rights & Permissions [Opens in a new window]

Abstract

Breast cancer is the second leading cause of death by cancer among women in the United States. The total cost of illness for breast cancer has been estimated to be $3.8 billion, of which $1.8 billion represents medical care costs. It has been estimated that breast cancer detected early is considerably less expensive than when the tumor is discovered at a later stage. Mass screening using mammography can improve early detection by as much as 15–35%. Cost-effectiveness studies have estimated that the costs of breast cancer screening range between $13,200 and $28,000 per year of life saved. The cost-effectiveness of breast cancer screening in the 40–49-year-old age group is controversial. Mass screening for breast cancer will probably increase total health care costs, but when all economic costs are included, screening appears to be more cost-effective than not screening.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 7 , Issue 4 , Fall 1991 , pp. 604 - 615
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.American Cancer Society. Survey of physicians' attitudes and practices in early cancer detection. Cancer, 1985, 35, 197–213.Google Scholar
2.Bailar, J. C.Screening for early breast cancer: Pros and cons. Cancer, 1977, 39, 2783–95.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
3.Brolin, R. E., & Wood, R.Letters. Journal of the American Medical Association, 1988, 260, 475.CrossRefGoogle Scholar
4.Carter, A. P., Thompson, R. S., Bourdeau, R. V., et al. A clinically effective breast cancer screening program can be cost-effective, too. Preventive Medicine, 1987, 16, 19–34.CrossRefGoogle ScholarPubMed
5.Caseldine, J., Dowle, C. S., Hinton, C. P., et al. Breast self-examination for early detection of breast cancer. Australia New Zealand Journal of Surgery, 1988, 58, 289–93.CrossRefGoogle ScholarPubMed
6.Clayman, C. B.Mass screening: Is it cost-effective? Journal of the American Medical Association, 1980, 243, 2065–68.Google ScholarPubMed
7.Council on Scientific Affairs. Mammographic screening in asymptomatic women aged 40 years and older. Journal of the American Medical Association, 1989, 261, 2535–42.CrossRefGoogle Scholar
8.Day, N. E., Baines, J., Chamberlain, J., et al. UICC project on screening for cancer: Report of the workshop on screening for breast cancer. International Journal of Cancer, 1986, 38, 303-08.CrossRefGoogle ScholarPubMed
9.Day, N. E., & Chamberlain, J.Screening for breast cancer workshop report. Cancer, 1987, 6A(suppl.), 55–59.Google Scholar
10.Dodd, G.Present status of thermography, ultrasound and mammography in breast cancer detection. Cancer, 1977, 39, 2796–805.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
11.Dodd, G. D., & Winchester, D.Issues, recommendations and solutions: Discussion group reports—National health professional organizations. Cancer, 1987, 60, 1694.3.0.CO;2-#>CrossRefGoogle Scholar
12.Early Detection of Breast Cancer Group. First results of mortality reduction in the UK trial of early detection of breast cancer. Lancet, 1988, ii, 411–16.Google Scholar
13.Eddy, D. M., Hasselblad, V., McGivney, W., & Hendee, W.The value of mammography screening in women under age 50 years. Journal of the American Medical Association, 1988, 259, 1512–19.CrossRefGoogle ScholarPubMed
14.Egan, R. L., & Egan, K. L.Detection of breast carcinoma: Comparison of automated waterpath whole-breast sonography, mammography, and physical examination. American Journal of Roentgenology, 1984, 143, 493–97.CrossRefGoogle ScholarPubMed
15.Fisher, B., Slack, N. H., & Bross, I. D.Cancer of the breast: Size of neoplasm and prognosis. Cancer, 1969, 24, 1071.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
16.Forsyth, R. A.The mathematics of screening mammography. Medical Hypotheses, 1988, 26, 21–24.CrossRefGoogle ScholarPubMed
17.Gold, R. H., Basset, L. W., & Fox, S. A.Mammography screening: Successes and problems in implementing widespread use in the United States. Radiologic Clinics of North America, 1987, 25, 1039–46.CrossRefGoogle ScholarPubMed
18.Gravelle, H. S. E., Simpson, P. R., & Chamberlain, J.Breast cancer screening and health service costs. Journal of Health Economics, 1982, 1, 185–207.CrossRefGoogle ScholarPubMed
19.Hill, D., White, V., Jolley, D., & Mapperson, K.Self-examination of the breast: Is it beneficial? Meta-analysis of studies investigating breast self-examination and extent of disease in patients with breast cancer. British Medical Journal, 1988, 23, 271–75.CrossRefGoogle Scholar
20.Huguley, C. M., Brown, R. L., Greenberg, R. S., & Clark, W. S.Breast self-examination and survival from breast cancer. Cancer, 1988, 62, 1389–96.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
21.Kodlin, D.A note on the cost-benefit problem in screening for breast cancer. Methods of Information in Medicine, 1972, 11, 242–47.Google ScholarPubMed
22.Kopans, D. B.“Early” breast cancer detection using techniques other than mammography. American Journal of Roentgenology, 1984, 143, 465–68.CrossRefGoogle ScholarPubMed
23.Love, R. R., & Camilli, A. E.The value of screening. Cancer, 1981, 48, 489–94.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
24.McLelland, R.Low cost mass screening with mammography as a means of reducing overall mortality from breast cancer. Radiologic Clinics of North America, 1987, 25, 1007–13.CrossRefGoogle ScholarPubMed
25.Miller, A. B.Risk-benefit in mass screening programs for breast cancer. Seminars in Oncology, 1978, 5, 351–59.Google ScholarPubMed
26.MMWR. Provisional estimates from the National Health Interview Survey Supplement on Cancer Control—United States, January-March, 1987. Morbidity and Mortality Weekly Reports, 1988, 37(27), 417–20, 425.Google Scholar
27.Mooney, G.Breast cancer screening: A study in cost-effectiveness analysis. Social Science Medicine, 1982, 16, 1277–83.CrossRefGoogle ScholarPubMed
28.Moskowitz, M.Cost of screening for breast cancer. Radiologic Clinics of North America, 1987, 25, 1031–37.CrossRefGoogle ScholarPubMed
29.Moskowitz, M., & Fox, S. H.Cost analysis of aggressive breast cancer screening. Radiology, 1979, 130, 253–56.Google ScholarPubMed
30.National Cancer Institute, Division of Cancer Prevention and Control Surveillance Program. Cancer statistics review 1973–1986. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, 05 1989.Google Scholar
31.Office of Technology Assessment. Breast cancer screening for Medicare beneficiaries: Effectiveness, costs to Medicare and medical resources required. Office of Technology Assessment, 11 1987.Google Scholar
32.O'Malley, M. S., & Fletcher, S. W.Screening for breast cancer with breast self-examination. Journal of the American Medical Association, 1987, 257, 2197–202.Google ScholarPubMed
33.Palli, D., Del Turco, M. R., Buiatti, E., et al. A case study of the efficacy of a nonrandomized breast cancer screening program in Florence (Italy). International Journal of Cancer, 1986, 38, 501–04.CrossRefGoogle Scholar
34.Schwartz, R. M., & Rollins, P. M.Measuring the cost-benefit of wellness strategies. Business and Health, 1985, 85, 24–26.Google Scholar
35.Scitovsky, A. A., & McCall, N.Economic impact of breast cancer. Frontiers of Radiation Therapy and Oncology, 1976, 11, 90–101.CrossRefGoogle Scholar
36.Seidman, H., Gelb, S. K., Silverberg, E., et al. Survival experience in the breast cancer detection demonstration project. Cancer, 1987, 37, 258–90.Google ScholarPubMed
37.Seidman, H., & Mushinski, M. H. Breast cancer diagnosis: Incidence, mortality, survival, and prognosis. In Fieg, S. A. & Mclelland, R. (eds.), Current diagnosis and treatment. New York: ACR & Masson, 1983, 9–46.Google Scholar
38.Shapiro, S.Evidence on screening for breast cancer from a randomized trial. Cancer, 1977, 39(suppl.), 2772–82.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
39.Sickles, E. A., Weber, W. N., Galvin, H. B., et al. Mammography screening: How to operate successfully at low cost. Radiology, 1986, 160, 95–97.CrossRefGoogle ScholarPubMed
40.Skrabanek, P.Mass mammography: The time for reappraisal. International Journal of Technology Assessment in Health Care, 1989, 5, 423–30.CrossRefGoogle ScholarPubMed
41. Statistical Bulletin, 07—09, 1985, 4–9.Google Scholar
42.Strax, P., & Martin, G.Principles in mass screening for breast cancer. Cancer Detection and Prevention, 1987, 10, 229–32.Google ScholarPubMed
43.Tabar, L., Gad, A., Holmberg, L. H., et al. Reduction in mortality from breast cancer after mass screening with mammography. Lancet, 1985, i, 829–32.CrossRefGoogle Scholar
44.Tifft, J. G., & Jarjoura, D.Breast cancer screening in a private women's clinic. American Journal of Obstetrics and Gynecology, 1988, 158, 1402–07.CrossRefGoogle Scholar
45.Wald, N., Frost, C., Cuckle, H., & Oppenheimer, P.Breast cancer screening (letter). Lancet, i, 1987, 859.Google Scholar
46.Walter, S. D., & Day, N. E.Estimation of the duration of a pre-clinical disease state using screening data. American Journal of Epidemiology, 1983, 118, 865–86.CrossRefGoogle ScholarPubMed
47.Verbeek, A. L. M., Hendricks, J., Holland, R., et al. Mammographic screening and breast cancer mortality: Age-specific effects in Nijmegen Project, 1975–82. Lancet, 1985, i, 865–66.CrossRefGoogle Scholar