geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Cost-effectiveness of digital mammography breast cancer screening


, : Cost-effectiveness of digital mammography breast cancer screening. Annals of Internal Medicine 148(1): 1-10

Background: The DMIST (Digital Mammography Imaging Screening Trial) reported improved breast cancer detection with digital mammography compared with film mammography in selected population subgroups, but it did not assess the economic value of digital relative to film mammography screening.Objective: To evaluate the cost-effectiveness of digital mammography screening for breast cancer.Design: Validated, discrete-event simulation model.Data Sources: Data from DMIST and publicly available U.S. data.Target Population: U.S. women age 40 years or older.Time Horizon: Lifetime.Perspective: Societal and Medicare.Intervention: All-film mammography screening; all-digital mammography screening; and targeted digital mammography screening, which is age-targeted digital mammography (for women <50 years of age) and age- and density-targeted digital mammography (for women <50 years of age or women >= 50 years of age with dense breasts).Outcome Measures: Cost per quality-adjusted life-year (QALY) gained. Results of Base-Case Analysis: All-digital mammography screening cost $331 000 (95% Cl, $268 000 to $403 000) per QALY gained relative to all-film mammography screening but was more costly and less effective than targeted digital mammography screening. Targeted digital mammography screening resulted in more screen-detected cases of cancer and fewer deaths from cancer than either all-film or all-digital mammography screening, with cost-effectiveness estimates ranging from $26 500 (Cl, $21 000 to $33 000) per QALY gained for age-targeted digital mammography to $84 500 (Cl, $75 000 to $93 000) per QALY gained for age-and density-targeted digital mammography. In the Medicare population, the cost-effectiveness of density-targeted digital mammography screening varied from a base-case estimate of $97 000 (Cl, $77 000 to $131 000) to $257 000 per QALY gained (Cl, $91 000 to $536 000) in the alternative-case analyses, in which the sensitivity of film mammography was increased and the sensitivity of digital mammography in women with nondense breasts was decreased.Results of Sensitivity Analysis: Results were sensitive to the cost of digital mammography and to the prevalence of dense breasts.Limitations: Results were dependent on model assumptions and DMIST findings.Conclusion: Relative to film mammography, screening for breast cancer by using all-digital mammography is not cost-effective. Age-targeted screening with digital mammography seems cost-effective, whereas density-targeted screening strategies are more costly and of uncertain value, particularly among women age 65 years or older.

US$19.90

PMID: 18166758

DOI: 10.7326/0003-4819-148-1-200801010-00002


Other references

Brown, P.P.; Mack, M.J.; Simon, A.W.; Battaglia, S.L.; Tarkington, L.G.; Culler, S.D.; Becker, E.R., 2001: Comparing clinical outcomes in high-volume and low-volume off-pump coronary bypass operation programs. sites and then analyzed the patient and hospital characteristics that had an impact on clinical outcomes. The mortality rates for the high- and low-volume OPCAB facilities both averaged 2.9% (p = NS). Patients at the high-volume OPCAB facilities h...

D. yakonova T.F., 1989: Tectonic fault of Talin Platform and its relation to petroleum potential. Continental sediments of the Tyumen Formation of Jurassic age are the most productive in the Talinskaya area of the Krasnoleninsky petroleum producing region. Formations involved occur either directly in the weathered formations of the heterogenou...

Hoshino T., 1988: An evaluation of fat content via image analysis of the carcasses of three different beef steer breeds. The aim of this study was to evaluate the extent of fat deposition on the cross section of a dressed carcass via the automated morphometry of an image analyzer. Six Japanese Black (JB), six Japanese Shorthorn (JN) and three crossbred steers (F1) w...

Savel'ev, V.S.; Dumpe, Z.P.; Isaev, M.R.; Shestakov, V.A.; Zharkova, Z.K., 1973: Assessment of regional perfusion as a method of treatment of acute phlebothromboses (an experimental study). Eksperimental'naia Khirurgiia i Anesteziologiia 18(5): 28-32

Binkley, A.M.; Sparks, W.C., 1944: Station breeding onions for resistance to insects, purple blotch, and pink root. The immediate objective is to produce a thrips-resistant Mountain Danvers onion that carries the desirable characters of good bulb shape, type, color, and uniformity, with a capacity for dehydration and storage. In addition, there is needed a Swee...

Cogdell, Rj, 1983: Photosynthetic reaction centers Bacteria. Annual review of plant physiology4(34): 21-45

Ng, C.Y.; Huang, Y.H.; Chu, C.F.; Wu, T.C.; Liu, S.H., 2017: Risks for Staphylococcus aureus colonization in patients with psoriasis: a systematic review and meta-analysis. Evidence on whether patients with psoriasis have a higher risk for staphylococcal colonization than healthy controls remains controversial. To synthesize the current literature, we performed a systematic review on the prevalence and relative risk...

Anonymous, 1993: Agricultural statistics in 1991. Information on crops, livestock numbers, performance recording for milk and meat production, production of dairy products and economic aspects of agricultural production in Norway is presented in 199 tables.

Biró, G., 1969: Information content of end-plate potentials (short communication). Acta Biochimica et Biophysica; Academiae Scientiarum Hungaricae 4(4): 437-438

Prather, A.A.; Janicki-Deverts, D.; Hall, M.H.; Cohen, S., 2016: Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Short sleep duration and poor sleep continuity have been implicated in the susceptibility to infectious illness. However, prior research has relied on subjective measures of sleep, which are subject to recall bias. The aim of this study was to det...