[Economic evaluation of population-based mass screening for the early detection of cancer: a systematic review].
OBJECTIVE
The increasing premature mortality due to cancer has made population based screening programs for cervical,breast and colorectal cancers inevitable in Hungary. However, when confronted with limited resources, the aim is that, within the budget constrain, the greatest possible health gain should be "produced".


METHODS
The authors made a systematic review of the international literature concerning the cost-effectiveness of screening programs for the above tumours.


RESULTS
In case of cervical cancer the Papanicolaou test, in case of breast cancer the mammography meet the WHO criteria for population-based mass screening. The well-designed organised screening programs are more cost-effective than the opportunistic screening. Among sexually active women, according to structure the mobile screening buses, according to age group screening of the 30-39 years old women seems the most favourable. For breast cancer, screening the 60-70 years old population every second year is the reference strategy from a health economic perspective. The cost-effectiveness results of either increasing the frequency of screening, extending the program for other age groups, or selecting a high-risk population are contradictory. In case of colorectal cancer there is no screening method, which would meet the WHO criteria. The two-day FOBT seems the most favourable, followed by colonoscopy for positive results, in the 55-74 years old population every second year.


CONCLUSIONS
In addition to fulfilling requirements for a population-based screening method, the cost-effectiveness perspective should be taken into account.
Muszbek
Noémi
N
Népegészségügyi Iskola, Debreceni Egyetem, Debrecen, 4028, Hungary. mnoemi@hotmail.com
Koncz
Tamás
T
V  Hajdú
Piroska
P
Adány
Róza
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000191:economics / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015179:Colorectal Neoplasms / Q000191:economics / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D005060:Europe / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000453:epidemiology* / Q000401:mortality; D011159:Population Surveillance; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000453:epidemiology