Mammography screening in Norway: results from the first screening round in four counties and cost-effectiveness of a modeled nationwide screening.
OBJECTIVE
To evaluate whether the results of the first screening round in the Norwegian Breast Cancer Screening Program predict future mortality reduction and to explore the cost-effectiveness of the program.


METHODS
The results of surrogate measures were calculated and compared with the targets. A cost-effectiveness analysis was performed assuming a nationwide program starting in 1996 with an attendance rate of 80% and a mortality reduction of 30%.


RESULTS
The attendance rate was 79.5% and the detection rate was 0.67%. The proportion of invasive tumors smaller than 15 mm was 53.1%, and 21.7% of the patients who underwent axillary surgery had lymphatic metastasis. The C/E ratios were found to be 3750 US dollars (USD) per year of life saved and 86,045 USD per life saved.


CONCLUSIONS
The results of the first screening round will lead to a mortality reduction of at least 30%. The cost-effectiveness analysis shows that it is possible to run a highly cost-efficient screening program in Norway.
Cancer Registry of Norway, Montebello, Oslo. hw@kreftreg.no
H
H
Wang
R
R
Kåresen
A
A
Hervik
S O
SO
Thoresen
D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000517:prevention & control*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D005544:Forecasting; D006302:Health Services Research; D006801:Humans; D008327:Mammography / Q000191:economics* / Q000592:standards*; D008403:Mass Screening / Q000191:economics* / Q000592:standards*; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D015397:Program Evaluation; D026712:Value of Life