Cost-Effectiveness of Breast Cancer Screening Using Digital Mammography in Canada

Area of Science:

• Health Economics
• Oncology
• Public Health

Background:

• Evolving breast cancer treatments improve outcomes but increase financial burdens.
• The cost-effectiveness of mammography screening alongside modern treatments remains unclear.

Purpose of the Study:

• To evaluate the cost-effectiveness of population-based breast cancer screening within current treatment standards.
• To assess the impact of different screening schedules on clinical outcomes and treatment costs.

Main Methods:

• Utilized the OncoSim-Breast microsimulation model for economic evaluation.
• Modeled a birth cohort from 1975 until age 99, comparing five screening scenarios.
• Incorporated 2023 activity-based costing data for breast cancer treatment in Ontario, Canada.

Main Results:

• Screening initiated at age 40 improved outcomes (deaths averted, life-years gained, quality-adjusted life-years gained) and reduced treatment costs compared to age 50 initiation.
• Biennial screening from ages 40-74 was cost-saving versus biennial screening from ages 50-74.
• Annual screening from ages 40-74 was cost-effective, yielding the best outcomes.

Conclusions:

• Mammography screening, particularly when started earlier, is a cost-effective method for reducing breast cancer mortality.
• Increased investment in screening programs is recommended for single-payer health systems.
• Digital mammography is a valuable tool for reducing breast cancer mortality.