COST-EFFECTIVENESS OF BREAST-CANCER SCREENING IN SPAIN

In the last several years, the development of an effective breast canc er screening procedure has increased the possibility of the early dete ction of this cancer. We investigated the cost-effectiveness of a brea st cancer screening program to screen 100,000 women 50-64 years of age in Catalonia (Spain). The cost-effectiveness ratio was measured in te rms of the cost per cancer detected comparing program costs to the est imated number of cancers detected. We assumed a participation rate, se nsitivity, and specificity of 70%, 92%, and 94%, respectively, and tha t 0.36 breast cancers could be detected per 100 women screened. We est imated a total cost of $2.1 million with $1.4 million for the mammogra phic stage and $0.7 million for the detection of the true positive mam mographic results. The cost per woman screened was $30. We estimated t hat 252 cases of breast cancer could be detected with the program. The cost-effectiveness ratio obtained in this study was $8,424 per cancer detected. Sensitivity analysis has shown that cost-effectiveness resu lts are sensitive to the variations in the following variables: specif icity, cancer detection rate, and screening costs. In planning prevent ive programs, breast cancer screening should be considered one of the priorities.