ArticleJournal of the National Cancer Institute2020
Long-Term Outcomes and Cost-Effectiveness of Breast Cancer Screening With Digital Breast Tomosynthesis in the United States.
Article in Journal of the National Cancer Institute, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 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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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.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Health Economic Evaluations of Breast Cancer Screening Strategies: A Systematic Review Focusing on Methodology and Quality Assessment.Applied health economics and health policy · 2026Pooled it
- The cost-effectiveness of digital health interventions: A systematic review of the literature.Frontiers in public health · 2022Pooled it
- Changes in Use, Cost, and Value of Breast Cancer Screening Among Older Women in the US.Journal of general internal medicine · 2026Article
- Outcomes of Density-Targeted Supplemental Breast Magnetic Resonance Imaging Screening by Breast Cancer Risk: Long-Term Health and Economic Considerations.Annals of internal medicine · 2026Article
- Review of Artificial Intelligence Techniques for Breast Cancer Detection with Different Modalities: Mammography, Ultrasound, and Thermography Images.Bioengineering (Basel, Switzerland) · 2025Review
- Breast lesion classification via colorized mammograms and transfer learning in a novel CAD framework.Scientific reports · 2025Article
- Health Technologies and Impermissible Delays: The Case of Digital Breast Tomosynthesis.Science and engineering ethics · 2025Article
- Racial and ethnic disparities in conversion to mastectomy following lumpectomy.Breast cancer research and treatment · 2025Article
- Comparing the cost-benefit of breast cancer screening programs in rural and urban areas across four economic zones in China: a Markov modeling analysis.BMC public health · 2025Article
- Budget impact analysis of introducing digital breast tomosynthesis in breast cancer screening in Italy.La Radiologia medica · 2024Article
- Cost-Effectiveness Analysis of Digital Breast Tomosynthesis and Mammography in Breast Cancer Screening: A Markov Modeling Study.Journal of epidemiology and global health · 2024Article
- Cost-Effectiveness Analysis of Digital Breast Tomosynthesis Added to Synthetic Mammography in Breast Cancer Screening in Brazil.PharmacoEconomics - open · 2024Article
- A health equity framework to support the next generation of cancer population simulation models.Journal of the National Cancer Institute. Monographs · 2023Article
- Breast Cancer Risk Assessment in the AI Era: The Importance of Model Validation in Ethnically Diverse Cohorts.Radiology. Artificial intelligence · 2023Article
- Adapting the pre-trained convolutional neural networks to improve the anomaly detection and classification in mammographic images.Scientific reports · 2023Article
- Article
- Health Benefits and Cost-Effectiveness of Children's Oncology Group Breast Cancer Screening Guidelines for Chest-Irradiated Hodgkin Lymphoma Survivors.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- The ability of digital breast tomosynthesis to reduce additional examinations in older women.Frontiers in medicine · 2023Article
- A Primer to Cost-Effectiveness Analysis in Breast Cancer Imaging: A Review of the Literature.Cureus · 2022Review
- Costs and Effects of Implementing Digital Tomosynthesis in a Population-Based Breast Cancer Screening Program: Predictions Using Results from the To-Be Trial in Norway.PharmacoEconomics - open · 2022Article
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Authors and funding
16 authors at 12 institutions in 2 countries.
Funding
Abstract
backgroundDigital breast tomosynthesis (DBT) is increasingly being used for routine breast cancer screening. We projected the long-term impact and cost-effectiveness of DBT compared to conventional digital mammography (DM) for breast cancer screening in the United States.
methodsThree Cancer Intervention and Surveillance Modeling Network breast cancer models simulated US women ages 40 years and older undergoing breast cancer screening with either DBT or DM starting in 2011 and continuing for the lifetime of the cohort. Screening performance estimates were based on observational data; in an alternative scenario, we assumed 4% higher sensitivity for DBT. Analyses used federal payer perspective; costs and utilities were discounted at 3% annually. Outcomes included breast cancer deaths, quality-adjusted life-years (QALYs), false-positive examinations, costs, and incremental cost-effectiveness ratios (ICERs).
resultsCompared to DM, DBT screening resulted in a slight reduction in breast cancer deaths (range across models 0-0.21 per 1000 women), small increase in QALYs (1.97-3.27 per 1000 women), and a 24-28% reduction in false-positive exams (237-268 per 1000 women) relative to DM. ICERs ranged from $195 026 to $270 135 per QALY for DBT relative to DM. When assuming 4% higher DBT sensitivity, ICERs decreased to $130 533-$156 624 per QALY. ICERs were sensitive to DBT costs, decreasing to $78 731 to $168 883 and $52 918 to $118 048 when the additional cost of DBT was reduced to $36 and $26 (from baseline of $56), respectively.
conclusionDBT reduces false-positive exams while achieving similar or slightly improved health benefits. At current reimbursement rates, the additional costs of DBT screening are likely high relative to the benefits gained; however, DBT could be cost-effective at lower screening costs.
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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.