ECONOMIC-EVALUATION OF A MAMMOGRAPHY-BASED BREAST-CANCER SCREENING-PROGRAM IN SPAIN

The aim of the study was to perform a cost-effectiveness analysis of a breast cancer (BC) mammography screening programme, compared to a do- nothing alternative, in Spain. Screening consisted of a biennial mammo graphy performed on ail women 50-65 years old. A marginal analysis inc luding women 45-49 years old was also performed. With the aid of a dec ision tree model, the numbers of BC cases diagnosed through screening, BC cases missed by screening and false-positive BC cases were calcula ted. Costs were calculated by feeding local data into Markovian models and the cost-effectiveness ratio calculation was performed in a compu ter spread sheet. A sensitivity analysis was also conducted. Results w ere presented in ECUs of 1993. The cost-effectiveness ratio per avoide d death is 115,500 ECUs and per saved life year 7,300 ECUs. Including women 45-49 years old in the programme raises this ratio to 229,000 an d 9,400 ECUs respectively. The sensitivity analysis showed the efficac y of mammography, compliance of the programme and screening costs to b e the more sensitive variables.