Economic evaluation of breast cancer screening - A review

PURPOSE: The authors provide a review: of the economic evaluation literatur e of breast cancer screening and identify important trends and gaps in the literature. OVERVIEW: Healthcare resources ate limited and economic evaluation plays a critical role in resource allocation, healthcare policy, and clinical decis ions. Many economic evaluations of medical practice, however, are unreliabl e and do not use appropriate analytic techniques. Three important trends we re observed. First, two economic evaluation methods are dominant. Second, a wide range of cost estimates exists across studies. Third, a lack of stand ardization exists across studies with regard to basic economic evaluation p rinciples. These findings should be considered when conducting future resea rch, analyzing economic evaluations of breast cancer screening, and develop ing clinical guidelines. CLINICAL IMPLICATIONS: Concerns about cost containment in healthcare make i t necessary for physicians and clinical administrators to take an active ro le in resource allocation decisions at the clinical la el. For instance, th e recent debate on the proper age to begin annual mammography screening inv olves both resource allocation and clinical issues. Thus, it is important f or physicians and clinical administrators to be familiar with the economic evaluation literature of breast cancer screening, economic evaluation metho dology and the associated shortcomings of published estimates.