ArticlePloS one2013
Cost-effectiveness analysis of breast cancer control interventions in Peru.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Economic evaluations of mammography to screen for breast cancer in low- and middle-income countries: A systematic review.Journal of global health · 2022Pooled it
- Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean: A Systematic Review.PharmacoEconomics · 2021Pooled it
- A Systematic Review of the Cost-Effectiveness of Screening Modalities for Breast Cancer in European Countries.Cancers · 2025Review
- Article
- Promoter hypermethylation of RARB and GSTP1 genes in plasma cell-free DNA as breast cancer biomarkers in Peruvian women.Molecular genetics & genomic medicine · 2023Article
- Cost-effectiveness of clinical breast examination screening programme among HER2-positive breast cancer patients: a modelling study.Breast cancer (Tokyo, Japan) · 2023Article
- Is Korean society prepared for the financial burden of novel anticancer drugs? A survey of willingness to pay among National Health Insurance beneficiaries.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Cost-Effectiveness of Population Level and Individual Level Interventions to Combat Non-communicable Disease in Eastern Sub-Saharan Africa and South East Asia: A WHO-CHOICE Analysis.International journal of health policy and management · 2021Article
- Economic Evaluations of Breast Cancer Care in Low- and Middle-Income Countries: A Scoping Review.The oncologist · 2021Article
- The current situation regarding the availability and accessibility of anticancer drugs for breast cancer in the Peruvian public health systems.Ecancermedicalscience · 2021Article
- Breast cancer mortality trends in Peruvian women.BMC cancer · 2020Article
- Positive cancer care in Peru: Patient and provider perspectives.Health care for women international · 2020Article
- Cost-effectiveness of community-based gendered advisory services to farmers: Analysis in Mozambique and Tanzania.PloS one · 2019Article
- Access to high-cost drugs for advanced breast cancer in Latin America, particularly trastuzumab.Ecancermedicalscience · 2019Review
- Early detection and treatment strategies for breast cancer in low-income and upper middle-income countries: a modelling study.The Lancet. Global health · 2018Article
- "The disease is mine, the body is mine, I decide": Individual, interpersonal, and institutional barriers and facilitators among survivors of women's cancers in Andean countries.Health care for women international · 2018Article
- Association of Previous Clinical Breast Examination With Reduced Delays and Earlier-Stage Breast Cancer Diagnosis Among Women in Peru.JAMA oncology · 2017Article
- Improving Access to Cancer Treatments: The Role of Biosimilars.Journal of global oncology · 2017Article
- A Micro CT Study in Patients with Breast Microcalcifications Using a Mathematical Algorithm to Assess 3D Structure.PloS one · 2017Article
- Cost-effectiveness thresholds: pros and cons.Bulletin of the World Health Organization · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIn Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant for the Peruvian context.
methodsWe performed a cost-effectiveness analysis (CEA) according to WHO-CHOICE guidelines, from a healthcare perspective. Different screening, early detection, palliative, and treatment interventions were evaluated using mathematical modeling. Effectiveness estimates were based on observational studies, modeling, and on information from Instituto Nacional de Enfermedades Neoplásicas (INEN). Resource utilizations and unit costs were based on estimates from INEN and observational studies. Cost-effectiveness estimates are in 2012 United States dollars (US$) per disability adjusted life year (DALY) averted.
resultsThe current breast cancer program in Peru ($8,426 per DALY averted) could be improved through implementing triennial or biennial screening strategies. These strategies seem the most cost-effective in Peru, particularly when mobile mammography is applied (from $4,125 per DALY averted), or when both CBE screening and mammography screening are combined (from $4,239 per DALY averted). Triennially, these interventions costs between $63 million and $72 million per year. Late stage treatment, trastuzumab therapy and annual screening strategies are the least cost-effective.
conclusionsOur analysis suggests that breast cancer control in Peru should be oriented towards early detection through combining fixed and mobile mammography screening (age 45-69) triennially. However, a phased introduction of triennial CBE screening (age 40-69) with upfront FNA in non-urban settings, and both CBE (age 40-49) and fixed mammography screening (age 50-69) in urban settings, seems a more feasible option and is also cost-effective. The implementation of this intervention is only meaningful if awareness raising, diagnostic, referral, treatment and basic palliative services are simultaneously improved, and if financial and organizational barriers to these services are reduced.
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