ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2021
Cost-effectiveness Analysis of Breast Cancer Screening Using Mammography in Singapore: A Modeling Study.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Quality-adjusted life years in the presence and absence of organized mammographic screening using data from BreastScreen Norway.International journal of cancer · 2026Article
- The Early Cost-Effectiveness of a Novel Scalp Cooling Device to Alleviate Chemotherapy-Induced Alopecia in Patients with Early Breast Cancer.ClinicoEconomics and outcomes research : CEOR · 2026Article
- A cost-effective breast cancer screening strategy for Urban China: Findings from a Shenzhen-based modeling study.PloS one · 2026Article
- Profile of the BREATHE cohort for risk-based breast screening in Singapore.Scientific reports · 2025Article
- Evaluating the Impact of a Clinical Breast Examination Screening Program within the IraPEN Project.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Will Absolute Risk Estimation for Time to Next Screen Work for an Asian Mammography Screening Population?Cancers · 2023Article
- Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province.Scientific reports · 2023Article
- Cost-benefit Analysis of Breast Cancer Screening with Digital Mammography: A Systematic Review.Medical journal of the Islamic Republic of Iran · 2023Review
- Breast Cancer in Asia: Incidence, Mortality, Early Detection, Mammography Programs, and Risk-Based Screening Initiatives.Cancers · 2022Review
- Advances in breast cancer screening modalities and status of global screening programs.Chronic diseases and translational medicine · 2022Review
- BREAst screening Tailored for HEr (BREATHE)-A study protocol on personalised risk-based breast cancer screening programme.PloS one · 2022Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundLimited research is available on the cost-effectiveness of breast cancer screening programs in Asian countries. We evaluated the cost-effectiveness of Singapore's national mammography screening program, implemented in 2002, recommending annual screening between ages 40 and 49 and biennial screening between ages 50 and 69, and alternative screening scenarios taking into account important country-specific factors.
methodsWe used national data from Singapore in the MIcrosimulation SCreening ANalysis-Fatal diameter (MISCAN-Fadia) model to simulate 302 screening scenarios for 10 million women born between 1910 and 1969. Screening scenarios varied by starting and ending age, screening interval, and attendance. Outcome measures included life-years gained (LYG), breast cancer deaths averted, false positives, overdiagnosis, quality-adjusted life years (QALY), costs (in 2002 Singapore dollars; S$), and incremental cost-effectiveness ratios (ICER). Costs and effects were calculated and discounted with 3% using a health care provider's perspective.
resultsSingapore's current screening program at observed attendance levels required 54,158 mammograms per 100,000 women, yielded 1,054 LYG, and averted 57 breast cancer deaths. At attendance rates ≥50%, the current program was near the efficiency frontier. Most scenarios on the efficiency frontier started screening at age 40. The ICERs of the scenarios on the efficiency frontiers ranged between S$10,186 and S$56,306/QALY, which is considered cost-effective at a willingness-to-pay threshold of S$70,000/QALY gained.
conclusionsSingapore's current screening program lies near the efficiency frontier, and starting screening at age 40 or 45 is cost-effective. Furthermore, enhancing screening attendance rates would increase benefits while maintaining cost-effectiveness. IMPACT: Screening all women at age 40 or 45 is cost-efficient in Singapore, and a policy change may be considered.
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