Cost-effectiveness of opportunistic versus organised mammography screening in Switzerland

Détails

ID Serval
serval:BIB_646FE1AC4654
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Cost-effectiveness of opportunistic versus organised mammography screening in Switzerland
Périodique
European journal of cancer
Auteur(s)
de Gelder Rianne, Bulliard Jean-Luc, de Wolf Chris, Fracheboud Jacques, Draisma Gerrit, Schopper Doris, De Koning Harry J.
ISSN
1879-0852[electronic]
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
45
Numéro
1
Pages
127-138
Langue
anglais
Résumé
BACKGROUND: Various centralised mammography screening programmes have shown to reduce breast cancer mortality at reasonable costs. However, mammography screening is not necessarily cost-effective in every situation. Opportunistic screening, the predominant screening modality in several European countries, may under certain circumstances be a cost-effective alternative. In this study, we compared the cost-effectiveness of both screening modalities in Switzerland. METHODS: Using micro-simulation modelling, we predicted the effects and costs of biennial mammography screening for 50-69 years old women between 1999 and 2020, in the Swiss female population aged 30-70 in 1999. A sensitivity analysis on the test sensitivity of opportunistic screening was performed. RESULTS: Organised mammography screening with an 80% participation rate yielded a breast cancer mortality reduction of 13%. Twenty years after the start of screening, the predicted annual breast cancer mortality was 25% lower than in a situation without screening. The 3% discounted cost-effectiveness ratio of organised mammography screening was euro11,512 per life year gained. Opportunistic screening with a similar participation rate was comparably effective, but at twice the costs: euro22,671-24,707 per life year gained. This was mainly related to the high costs of opportunistic mammography and frequent use of imaging diagnostics in combination with an opportunistic mammogram. CONCLUSION: Although data on the performance of opportunistic screening are limited, both opportunistic and organised mammography screening seem effective in reducing breast cancer mortality in Switzerland. However, for opportunistic screening to become equally cost-effective as organised screening, costs and use of additional diagnostics should be reduced.
Mots-clé
Aged, Breast Neoplasms, Breast Neoplasms/mortality, Breast Neoplasms/radiography, Calibration, Computer Simulation, Cost-Benefit Analysis, Early Detection of Cancer, Female, Health Care Costs, Humans, Mammography, Mammography/economics, Mammography/methods, Mass Screening, Mass Screening/economics, Mass Screening/methods, Middle Aged, Models, Econometric, Quality-Adjusted Life Years, Sensitivity and Specificity, Switzerland
Pubmed
Web of science
Création de la notice
13/03/2009 15:19
Dernière modification de la notice
20/08/2019 15:20
Données d'usage