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Abstract:
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Breast cancer screening strategies combining mammography and clinical breast exam are considered to be effective in the early detection of breast cancer. In this study, we assess the cost-effectiveness of various screening strategies combining these two modalities. We account for factors that impact the performance of a screening program including age-specific incidence, pre-clinical duration of the disease, screening sensitivity and specificity, and treatments. The outcomes of interest are quality-adjusted years of life saved and incurred costs. We compare ten strategies in a comprehensive Monte Carlo simulation, taking into consideration costs involving screening exams, biopsy caused by false-positive exams and subsequent treatments. Our results indicate that a cost-effective screening program gives mammography and clinical breast exam in alternating years from ages 40 to 79.
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