Breast cancer screening by mammography in Norway. Is it cost-effective?

Background: Mammography screening is a promising method for improving progn osis in breast cancer. Patients and methods: In this economic analysis, data from the Norwegian Ma mmography Project (NMP), the National Health Administration (NMA) and the N orwegian Medical Association (NMA) were employed in a model for cost-effect iveness analysis. According to the annual report of the NMP for 1996, 60,14 7 women aged 50-69 years had been invited to a two-yearly mammographic scre ening programme. 46,329 (77%) had been screened and 337 (0.7%) breast cance rs had been revealed. The use of breast conserving surgery (BCS) was in thi s study estimated raised by 17% due to screening, the breast cancer mortali ty decreased by 30% and the number of life years saved per prevented breast cancer death was calculated 15 years. Results: The cost per woman screened was calculated pound 75.4, the cost pe r cancer detected pound 10,365 and the cost per life year (LY) saved pound 8,561. A raised frequency of BCS, diagnosis and adjuvant chemotherapy broug ht two years forward, follow-up costs and costs/savings due to prevented br east cancer deaths were all included in the analysis. A sensitivity analysi s documented mammography screening cost-effective in Norway when four to ni ne years are gained per prevented breast cancer death. Conclusion: Mammography screening in Norway looks cost-effective. Time has come to encourage national screening programmes.