SCREENING MAMMOGRAPHY IN WOMEN AGED 40-49 YEARS - ANALYSIS OF COST-EFFECTIVENESS

PURPOSE: To evaluate the cost-effectiveness of screening mammography i n women 40-49 years old. MATERLALS AND METHODS: A Markov model compare d two hypothetical groups; one underwent screening mammography and the other, observation without mammography. Variables tested included fre quency of mammography, reduction in breast cancer mortality, and cost- effectiveness by age group. Results were expressed as marginal cost pe r year of life saved. RESULTS: If the estimated mortality reduction fr om mammographic screening was 15% or greater, the marginal cost per ye ar of life saved was comparable to that of other generally accepted me dical procedures. Annual screening with an assumed 30% reduction in mo rtality had a cost-effectiveness similar to that of biennial screening with a 20% reduction. Screening mammography was less cost-effective i n the 40-49-year-old age group than in women aged 50-79 years but more cost-effective than in those aged 80-84 years. CONCLUSION: Although t he parameters for screening mammography in women aged 40-49 years are not known with certainty, the results of this analysis may help establ ish priorities for utilization of medical resources.