![]() ![]() Mammography and clinical breast exam in alternating years from ages 40 to 79 years was a cost-effective alternative compared with the guidelines, costing $35,500 per QALY saved compared with no screening. Preventive Services Task Force, alternative strategies were more efficient. Results: Compared with guidelines from the National Cancer Institute and the U.S. Sensitivity analyses were done by varying some of the assumptions. Incremental cost-effectiveness ratios were used to compare strategies. The outcomes of interest were quality-adjusted life years (QALY) saved and total costs with a 3% annual discount rate. Using statistical models, we accounted for age-specific incidence, preclinical disease duration, and age-specific sensitivity and specificity for each screening modality. Methods: We used a microsimulation model to generate women's life histories, and assessed screening and treatment effects on survival. We considered costs of screening examinations, subsequent work-up, biopsy, and treatment interventions after diagnosis. In this study, we assessed the cost-effectiveness of screening schedules recommended by three major cancer organizations and compared them with alternative strategies. Previous cost-effectiveness studies considered mammography alone or did not account for all relevant costs. Purpose: Breast cancer screening by mammography and clinical breast exam are commonly used for early tumor detection. ![]()
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