Breast cancer screening by mammography in Norway. Is it cost-effective?
BACKGROUND
Mammography screening is a promising method for improving prognosis in breast cancer.


METHODS
In this economic analysis, data from the Norwegian Mammography Project (NMP), the National Health Administration (NMA) and the Norwegian Medical Association (NMA) were employed in a model for cost-effectiveness analysis. According to the annual report of the NMP for 1996, 60,147 women aged 50-69 years had been invited to a two-yearly mammographic screening programme 46,329 (77%) had been screened and 337 (0.7%) breast cancers had been revealed. The use of breast conserving surgery (BCS) was in this study estimated raised by 17% due to screening, the breast cancer mortality 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 75.4 Pounds, the cost per cancer detected 10.365 Pounds and the cost per life year (LY) saved 8.561 Pounds. A raised frequency of BCS, diagnosis and adjuvant chemotherapy brought two years forward, follow-up costs and costs/savings due to prevented breast cancer deaths were all included in the analysis. A sensitivity analysis documented mammography screening cost-effective in Norway when four to nine years are gained per prevented breast cancer death.


CONCLUSIONS
Mammography screening in Norway looks cost-effective. Time has come to encourage national screening programmes.
Norum
J
J
Department of Oncology, University hospital of Tromso, Norway. jannorum@fagmed.uit.no
D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008327:Mammography / Q000191:economics*; D008875:Middle Aged; D009664:Norway