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Incremental cost-effectiveness of double-reading mammograms.
T Leivo1, T Salminen, H Sintonen
1Department of Public Health, University of Helsinki, Finland. tiina.leivo@pp.fimnet.fi
Breast Cancer Research and Treatment
|August 13, 1999
Summary
Double reading in breast cancer screening finds more cancers, but at a higher cost per case. This strategy increases costs by 39% for each additional cancer detected.
Area of Science:
- Radiology
- Public Health
- Health Economics
Background:
- Double reading is a standard in breast cancer screening.
- Evidence on its cost-effectiveness is limited.
- This study assesses the incremental cost-effectiveness of double reading.
Purpose of the Study:
- To evaluate the cost-effectiveness of double reading versus single reading in breast cancer screening.
- To determine the incremental cost per additional cancer detected by double reading.
Main Methods:
- A nationwide, population-based cost-effectiveness analysis was conducted.
- Data from 95,423 mammograms in Finland (1990-1995) were analyzed.
- Incremental costs and cancers detected by single vs. double reading were compared.
Main Results:
- Double reading detected 290 cancers versus 261 with single reading.
- The incremental cost per additional cancer found was US$ 25,523 (39% higher than single reading).
- A higher proportion of carcinoma in situ cancers were detected by the second reader.
Conclusions:
- The additional cost per cancer detected by double reading is not prohibitively high.
- However, the cost per life year saved may be significantly greater.
- Further economic evaluation is needed for screening strategies.