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Screening mammography in women aged 40-49 years: analysis of cost-effectiveness
1Department of Radiology, University of California, Davis, School of Medicine, Sacramento 95817.
Purpose:
To evaluate the cost-effectiveness of screening mammography in women 40-49 years old.
Materials And Methods:
A Markov model compared two hypothetical groups; one underwent screening mammography and the other, observation without mammography. Variables tested included frequency of mammography, reduction in breast cancer mortality, and cost-effectiveness by age group. Results were expressed as marginal cost per year of life saved.
Results:
If the estimated mortality reduction from mammographic screening was 15% or greater, the marginal cost per year of life saved was comparable to that of other generally accepted medical procedures. Annual screening with an assumed 30% reduction in mortality had a cost-effectiveness similar to that of biennial screening with a 20% reduction. Screening mammography was less cost-effective in the 40-49-year-old age group than in women aged 50-79 years but more cost-effective than in those aged 80-84 years.
Conclusion:
Although the parameters for screening mammography in women aged 40-49 years are not known with certainty, the results of this analysis may help establish priorities for utilization of medical resources.