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The mathematics of screening mammography
1Department of Family Practice, Kaiser Permanente Medical Center, Pasadena, CA 91101.
Medical Hypotheses
|May 1, 1988
Summary
Annual mammograms for women in their early fifties are costly and inefficient for detecting early-stage breast cancer. The study suggests screening mammography has a poor cost-benefit ratio for this population.
Area of Science:
- Oncology
- Radiology
- Public Health
Background:
- Mammography is a key tool for breast cancer screening.
- Early detection aims to improve patient survival rates.
- The cost-effectiveness of widespread screening is a significant public health concern.
Purpose of the Study:
- To evaluate the cost-benefit ratio of annual screening mammography in an unselected population of women in their early fifties.
- To determine the number of mammograms required to detect one early-stage, incidental breast cancer that contributes to survival.
Main Methods:
- Analysis of data from an unselected population of women aged approximately 50.
- Calculation of the number of mammograms needed per survivor.
- Estimation of the cost per survivor for early cancer detection.
Main Results:
- Approximately 7500 annual mammograms are needed per survivor identified.
- The cost associated with this level of screening is approximately $375,000 per survivor.
- Identified cancers were stage I and not detectable by physical examination.
Conclusions:
- Annual screening mammography in this demographic has a poor cost-benefit ratio.
- The high cost and low yield suggest limited value for unselected screening in women in their early fifties.
- Further research may be needed to identify optimal screening strategies and populations.
