[Cost of breast cancer screening]

The adoption in France of a national breast cancer screening policy will depend in part on economic factors. These include the investments and costs of screening and the cost-effectiveness of screening as compared to other health interventions. There exist few economic data on breast cancer screening in France. Existing studies have estimated the cost of screening at 374 FF per woman screened, however they provide no indication of the cost-effectiveness of screening. The application of cost-effectiveness ratios obtained in other countries is difficult given the strong presence of spontaneous screening which is unique in France. Spontaneous screening may undermine the marginal gain in life expectancy expected from organized screening, however it does not offer the quality of organized screening in terms of systematic double reading and quality assurance of mammographic units. Precise and reliable data on the costs and effectiveness associated with both these forms of screening must be collected before reaching any conclusions on cost-effectiveness. These data will allow for the development of a coherent and equitable policy on screening in France which is justified both in economic terms and in terms of public health.