Cost-effectiveness of breast cancer screening in the National Breast and Cervical Cancer Early Detection Program
Cost-effectiveness of breast cancer screening in the National Breast and Cervical Cancer Early Detection Program
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DOI：
10.1007/s10552-019-01178-y
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发表时间：
2019-08-01
影响因子：
2.3
通讯作者：
Hoerger, Thomas J.
中科院分区：
文献类型：
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作者：
Rim, Sun Hee;Allaire, Benjamin T.;Hoerger, Thomas J.
目的评估国家乳腺癌和宫颈癌早期检测计划（NBCCEDP）中乳腺癌筛查的成本效益。方法使用改进的CISNET乳腺癌模拟模型，我们估计了40-64岁女性在三种情况下的结果：在NBCCEDP内进行乳腺癌筛查，在没有NBCCEDP的情况下进行筛查（没有计划），以及没有通过任何计划进行筛查。我们报告了筛查结果、成本、质量调整生命年（QALYs）、增量成本-效果比（ICERs）和敏感性分析结果。结果：与没有项目和没有筛查相比，NBCCEDP降低了乳腺癌死亡率，改善了QALYs，但增加了医疗成本。该方案的基础病例ICER为51,754美元/QALY vs .无方案，50,223美元/QALY vs .无筛查。与没有筛查相比，该方案的概率敏感性分析ICER为56,615美元/QALY [95% CI $24,069, 134,230美元/QALY]，与没有筛查相比，该方案的概率敏感性分析ICER为51,096美元/QALY [95% CI $26,423, 97,315美元/QALY]。结论平均而言，与没有筛查或没有筛查相比，NBCCEDP的乳腺癌筛查具有成本效益。
PurposeTo estimate the cost-effectiveness of breast cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).MethodsUsing a modified CISNET breast cancer simulation model, we estimated outcomes for women aged 40-64years associated with three scenarios: breast cancer screening within the NBCCEDP, screening in the absence of the NBCCEDP (no program), and no screening through any program. We report screening outcomes, cost, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and sensitivity analyses results.ResultsCompared with no program and no screening, the NBCCEDP lowers breast cancer mortality and improves QALYs, but raises health care costs. Base-case ICER for the program was $51,754/QALY versus no program and $50,223/QALY versus no screening. Probabilistic sensitivity analysis ICER for the program was $56,615/QALY [95% CI $24,069, $134,230/QALY] versus no program and $51,096/QALY gained [95% CI $26,423, $97,315/QALY] versus no screening.ConclusionsOn average, breast cancer screening in the NBCCEDP was cost-effective compared with no program or no screening.