Breast cancer screening programme in China: does one size fit all? A cost-effectiveness analysis based on a Markov model

The Lancet ◽  
2018 ◽  
Vol 392 ◽  
pp. S2 ◽  
Author(s):  
Li Sun ◽  
Rosa Legood ◽  
Zia Sadique ◽  
Isabel dos-Santos-Silva ◽  
Li Yang
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Markov Model ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme

scholarly journals Cost effectiveness analysis of a polygenic risk tailored breast cancer screening programme in Singapore

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jerry Zeng Yang Wong ◽  
Jia Hui Chai ◽  
Yen Shing Yeoh ◽  
Nur Khaliesah Mohamed Riza ◽  
Jenny Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Cost Effective ◽  
Polygenic Risk ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme ◽  
The Cost

Abstract Background This study aimed to evaluate the cost-effectiveness of a breast cancer screening programme that incorporates genetic testing using breast cancer associated single nucleotide polymorphisms (SNPs), against the current biennial mammogram-only screening programme to aid in its implementation into the current programme in Singapore. Methods A Markov model was used to compare the costs and health outcomes of the current screening programme, against a polygenic risk-tailored screening programme, which can advise a long-term screening strategy depending on the individual’s polygenic risk. The model took the perspective of the healthcare system, with a time horizon of 40 years, following women from the age of 35 to 74. Epidemiological and cost data were taken from Asian studies, and an annual discount rate of 3% was used. The model outcome was the incremental cost-effectiveness ratio (ICER), calculated from the difference in costs per quality-adjusted life year (QALY). Scenarios with varying risk thresholds for each polygenic risk group were examined. One-way and probabilistic sensitivity analyses were performed to assess parameter uncertainty. Results The ICER for a polygenic risk-tailored breast cancer screening programme, compared with the current biennial mammogram-only screening programme, was − 3713.80 SGD/QALY, with incremental costs < 0 and incremental effects > 0. The scenario analysis of different polygenic risk cutoffs showed that the ICERs remain negative, with all ICERs falling within the south-east quadrant of the cost-effectiveness plane, indicating that tailored screening is more cost effective than mammogram-only screening, with lower costs and higher QALYs to be gained. This suggests that a polygenic risk-tailored breast cancer screening programme is cost effective, entailing lower cost than the current mammogram-only programme, while causing no additional harm to women. Conclusion Results from this cost-effectiveness analysis show that polygenic risk-tailored screening is cost effective with an ICER of − 3713.80 SGD/QALY. Tailored screening remains cost effective even across varying percentile cutoffs for each risk group. While the results look promising for incorporating polygenic risk into the current breast cancer screening programme, further studies should be conducted to address various limitations.

scholarly journals Cost‐effectiveness of breast cancer screening programme for women in rural China

2018 ◽  
Vol 144 (10) ◽  
pp. 2596-2604 ◽  
Author(s):  
Li Sun ◽  
Zia Sadique ◽  
Isabel dos‐Santos‐Silva ◽  
Li Yang ◽  
Rosa Legood
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Rural China ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme

scholarly journals Cost Effectiveness Analysis of a Polygenic Risk Tailored Breast Cancer Screening Programme in Singapore

2021 ◽  
Author(s):  
Jerry Zeng Yang Wong ◽  
Jia Hui Chai ◽  
Yen Shing Yeoh ◽  
Nur Khaliesah Mohamed Riza ◽  
Jenny Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Cost Effective ◽  
Polygenic Risk ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme ◽  
The Cost

Abstract BackgroundThis study aimed to evaluate the cost effectiveness of a breast cancer screening programme that incorporates genetic testing using breast cancer associated single nucleotide polymorphisms (SNPs) in Singapore, against the current biennial mammogram only screening programme.MethodsA Markov model was used to compare the costs and health outcomes of the current screening programme, against a polygenic risk tailored screening programme that advises long term screening depending polygenic risk. The model took the perspective of the healthcare system, with a time horizon of 40 years, following women from the age of 35 to 74. Epidemiological and cost data was taken from Asian studies. An annual discount rate of 3% was used. The model outcome was the incremental cost-effectiveness ratio (ICER), calculated from the difference in costs per quality adjusted life year (QALY). Scenarios with varying risk thresholds for each polygenic risk group were examined. One-way and probabilistic sensitivity analyses were performed to assess parameter uncertainty.ResultsThe ICER for a polygenic risk tailored breast cancer screening programme, compared to the current biennial mammogram only screening programme, was -3,713.80, with incremental costs <0 and incremental effects >0. Scenario analysis of different polygenic risk cutoffs showed that the ICERs remain negative, with all ICERs falling within the south east quadrant of the cost effectiveness plane, indicating that tailored screening dominates mammogram only screening with lower costs and higher QALYs. This suggests that a polygenic risk tailored breast cancer screening programme is cost effective, being cheaper than the current mammogram only programme while bringing no additional harm to women.ConclusionResults from this cost effectiveness analysis show that polygenic risk tailored screening is cost effective with an ICER of –3,713.80 SGD/QALY. Tailored screening remains cost effective even when varying percentile cutoffs for each risk group. While the results look promising for incorporating polygenic risk into the current breast cancer screening programme, further studies should be conducted due to various limitations.

scholarly journals Lower attendance rates in immigrant versus non-immigrant women in the Norwegian Breast Cancer Screening Programme

2017 ◽  
Vol 25 (3) ◽  
pp. 155-161 ◽  
Author(s):  
Sameer Bhargava ◽  
Kaitlyn Tsuruda ◽  
Kåre Moen ◽  
Ida Bukholm ◽  
Solveig Hofvind
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Immigrant Women ◽  
Population Based ◽  
Mammographic Screening ◽  
Attendance Rates ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme

Objective The Norwegian Breast Cancer Screening Programme invites women aged 50–69 to biennial mammographic screening. Although 84% of invited women have attended at least once, attendance rates vary across the country. We investigated attendance rates among various immigrant groups compared with non-immigrants in the programme. Methods There were 4,053,691 invitations sent to 885,979 women between 1996 and 2015. Using individual level population-based data from the Cancer Registry and Statistics Norway, we examined percent attendance and calculated incidence rate ratios, comparing immigrants with non-immigrants, using Poisson regression, following women's first invitation to the programme and for ever having attended. Results Immigrant women had lower attendance rates than the rest of the population, both following the first invitation (53.1% versus 76.1%) and for ever having attended (66.9% versus 86.4%). Differences in attendance rates between non-immigrant and immigrant women were less pronounced, but still present, when adjusted for sociodemographic factors. We also identified differences in attendance between immigrant groups. Attendance increased with duration of residency in Norway. A subgroup analysis of migrants' daughters showed that 70.0% attended following the first invitation, while 82.3% had ever attended. Conclusions Immigrant women had lower breast cancer screening attendance rates. The rationale for immigrant women's non-attendance needs to be explored through further studies targeting women from various birth countries and regions.

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