Cost-effectiveness analysis of mass screening for breast cancer in Japan.
The official Japanese recommendation for breast cancer screening is physical examination by a physician, in contrast to US recommendations of mammography. In this analysis of breast cancer screening, the authors used Japanese data in a cost-effectiveness model to compare the following five strategies: (1) no screening (N); (2) physical examination alone (PE); (3) mammography (MG); (4) PE followed by MG if PE findings were abnormal (PE----MG); and (5) PE combined with MG for all screened women (PE + MG). None of these programs would save medical expenditures. The total discounted net costs per patient (in US dollars) were as follows: N, +54; PE, +412; MG, +517; PE----MG, +340; and PE + MG, +731. The number of years of life saved per cohort of 100,000 asymptomatic Japanese women would range from 708 (PE----MG) to 3724 (PG + MG). The additional cost of each strategy (compared with N) per additional year of life would be +49,700 for PE, +40,400 for PE----MG, +14,300 for MG, and +18,000 for PE + MG. The least costly screening option (PE----MG) does not have the lowest cost per additional year of life saved (MG does). MG would be preferable to the current Japanese recommendation of PE alone.
Okubo
I
I
Medical Economics Division, Japanese Ministry of Health and Welfare, Tokyo.
Glick
H
H
Frumkin
H
H
Eisenberg
J M
JM
D001943:Breast Neoplasms / Q000517:prevention & control*; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007564:Japan; D008327:Mammography / Q000191:economics; D008403:Mass Screening / Q000191:economics*; D008962:Models, Theoretical; D010808:Physical Examination / Q000191:economics; D012680:Sensitivity and Specificity