THE COSTS AND EFFECTS OF CERVICAL AND BREAST-CANCER SCREENING IN A PUBLIC HOSPITAL EMERGENCY ROOM

Objectives. This study assessed the cost-effectiveness of cervix and b reast cancer screening in a public hospital emergency room. Methods. A ge-eligible women with nonurgent conditions and without recent screeni ng wee offered screening by a nurse. A decision analysis compared the costs and outcomes of emergency room screening and standard hospital s creening efforts. Results. The undiscounted cost effectiveness results for establishing new programs were $4050 (cervical cancer), $403203 ( breast cancer), and $4375 (joint cervix and breast cancer) per year of life saved. If screening is added to an existing program, results are more favorable ($429,$21 324 and $479 per year of life saved for cerv ix, breast, and joint screening, respectively). Results were most sens itive to volume and probability of receiving treatment after an abnorm al screen. Conclusions. Emergency room screening was cost-effective fo r cervical cancer; breast cancer screening was relatively expensive gi ven the low number of women reached. More intensive recruitment and fo llow-up strategies are needed to maximize the cost-effectiveness of su ch programs.