ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2009
Cost-effectiveness analysis of mammography and clinical breast examination strategies: a comparison with current guidelines.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Recommendations on screening for breast cancer in average-risk women aged 40-74 years.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2011Guideline
- Advancing women's health in Egypt: an economic evaluation of the presidential initiative for nationwide breast cancer early detection and treatment.Archives of public health = Archives belges de sante publique · 2026Article
- Breast Cancer Disparities in African and African-Ancestry Populations: Genetics, Epigenetics, Structural Barriers and Technology-Enabled Solutions.British journal of biomedical science · 2026Review
- Long-term Outcomes of Early Breast Cancer Stratified by Axillary Ultrasound Assessment.Journal of breast cancer · 2025Article
- Artificial Intelligence in Breast Cancer Diagnosis and Personalized Medicine.Journal of breast cancer · 2023Review
- Incorporating Baseline Breast Density When Screening Women at Average Risk for Breast Cancer : A Cost-Effectiveness Analysis.Annals of internal medicine · 2021Article
- Patient Perception and Cost-Effectiveness of a Patient Navigation Program to Improve Breast Cancer Screening for Hispanic Women.Health equity · 2019Article
- A snapshot of cancer in Chile: analytical frameworks for developing a cancer policy.Biological research · 2015Review
- Cost-effectiveness of alternative strategies for integrating MRI into breast cancer screening for women at high risk.British journal of cancer · 2014Article
- Incorporating texture features in a computer-aided breast lesion diagnosis system for automated three-dimensional breast ultrasound.Journal of medical imaging (Bellingham, Wash.) · 2014Article
- Cost-effectiveness of health-related lifestyle advice delivered by peer or lay advisors: synthesis of evidence from a systematic review.Cost effectiveness and resource allocation : C/E · 2013Article
- Association between documented family history of cancer and screening for breast and colorectal cancer.Preventive medicine · 2013Article
- A Canadian screening program for hepatitis C: is now the time?CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2013Article
- Multicohort models in cost-effectiveness analysis: why aggregating estimates over multiple cohorts can hide useful information.Medical decision making : an international journal of the Society for Medical Decision Making · 2013Article
- Optimizing Canadian breast cancer screening strategies: a perspective for action.Canadian journal of public health = Revue canadienne de sante publique · 2012Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
purposeBreast cancer screening by mammography and clinical breast exam are commonly used for early tumor detection. Previous cost-effectiveness studies considered mammography alone or did not account for all relevant costs. In this study, we assessed the cost-effectiveness of screening schedules recommended by three major cancer organizations and compared them with alternative strategies. We considered costs of screening examinations, subsequent work-up, biopsy, and treatment interventions after diagnosis.
methodsWe used a microsimulation model to generate women's life histories, and assessed screening and treatment effects on survival. Using statistical models, we accounted for age-specific incidence, preclinical disease duration, and age-specific sensitivity and specificity for each screening modality. The outcomes of interest were quality-adjusted life years (QALY) saved and total costs with a 3% annual discount rate. Incremental cost-effectiveness ratios were used to compare strategies. Sensitivity analyses were done by varying some of the assumptions.
resultsCompared with guidelines from the National Cancer Institute and the U.S. Preventive Services Task Force, alternative strategies were more efficient. Mammography and clinical breast exam in alternating years from ages 40 to 79 years was a cost-effective alternative compared with the guidelines, costing $35,500 per QALY saved compared with no screening. The American Cancer Society guideline was the most effective and the most expensive, costing over $680,000 for an added QALY compared with the above alternative.
conclusionScreening strategies with lower costs and benefits comparable with those currently recommended should be considered for implementation in practice and for future guidelines.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.