title: Cost of services provided by the National Breast and Cervical Cancer Early Detection Program.
abstract: BACKGROUND
  The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is the largest cancer screening program for low-income women in the United States. This study updates previous estimates of the costs of delivering preventive cancer screening services in the NBCCEDP.
  
  
  METHODS
  We developed a standardized web-based cost-assessment tool to collect annual activity-based cost data on screening for breast and cervical cancer in the NBCCEDP. Data were collected from 63 of the 66 programs that received funding from the Centers for Disease Control and Prevention during the 2006/2007 fiscal year. We used these data to calculate costs of delivering preventive public health services in the program.
  
  
  RESULTS
  We estimated the total cost of all NBCCEDP services to be $296 (standard deviation [SD], $123) per woman served (including the estimated value of in-kind donations, which constituted approximately 15% of this total estimated cost). The estimated cost of screening and diagnostic services was $145 (SD, $38) per women served, which represented 57.7% of the total cost excluding the value of in-kind donations. Including the value of in-kind donations, the weighted mean cost of screening a woman for breast cancer was $110 with an office visit and $88 without, the weighted mean cost of a diagnostic procedure was $401, and the weighted mean cost per breast cancer detected was $35,480. For cervical cancer, the corresponding cost estimates were $61, $21, $415, and $18,995, respectively.
  
  
  CONCLUSIONS
  These NBCCEDP cost estimates may help policy makers in planning and implementing future costs for various potential changes to the program.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.forename: Sujha
authors.initials: S
authors.lastname: Subramanian
authors.forename: Justin G
authors.initials: JG
authors.lastname: Trogdon
authors.forename: Jacqueline W
authors.initials: JW
authors.lastname: Miller
authors.forename: Janet E
authors.initials: JE
authors.lastname: Royalty
authors.forename: Chunyu
authors.initials: C
authors.lastname: Li
authors.forename: Gery P
authors.initials: GP
authors.lastname: Guy
authors.forename: Wesley
authors.initials: W
authors.lastname: Crouse
authors.forename: Hope
authors.initials: H
authors.lastname: Thompson
authors.forename: James G
authors.initials: JG
authors.lastname: Gardner
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics*; D003365:Costs and Cost Analysis; D003625:Data Collection; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods*; D005260:Female; D006801:Humans; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000191:economics*
keywords: NBCCEDP; breast cancer screening; cervical cancer screening; cost analysis; economic cost; program evaluation
references.citation: Prev Med. 1998 Jan-Feb;27(1):13-31
references.pmid: 9465350
references.citation: CA Cancer J Clin. 2008 Jan-Feb;58(1):9-31
references.pmid: 18096863
references.citation: Cancer. 2007 Jan 15;109(2 Suppl):359-67
references.pmid: 17123275
references.citation: Lancet Oncol. 2008 Mar;9(3):222-31
references.pmid: 18282806
references.citation: Am J Prev Med. 2009 Sep;37(3):242-7
references.pmid: 19666160
references.citation: Curr Med Res Opin. 2008 Sep;24(9):2429-35
references.pmid: 18662493
references.citation: JAMA. 2003 Aug 13;290(6):781-9
references.pmid: 12915431
references.citation: Cancer Epidemiol Biomarkers Prev. 2002 Jan;11(1):59-71
references.pmid: 11815402
references.citation: Cancer. 2009 Dec 1;115(23):5394-403
references.pmid: 19685528
references.citation: Cancer. 2014 Aug 15;120 Suppl 16:2540-8
references.pmid: 25099896
references.citation: Cancer. 2008 Aug 1;113(3):592-601
references.pmid: 18536027
references.citation: Ann Intern Med. 2011 Jul 5;155(1):10-20
references.pmid: 21727289
references.citation: Cancer. 2004 Apr 15;100(8):1595-604
references.pmid: 15073845
references.citation: Am J Prev Med. 2011 Apr;40(4):397-404
references.pmid: 21406272
references.citation: Cancer Epidemiol Biomarkers Prev. 1998 Oct;7(10):951-61
references.pmid: 9796642
references.citation: J Natl Cancer Inst. 2001 Nov 21;93(22):1704-13
references.pmid: 11717331
references.citation: J Health Care Poor Underserved. 2002 Aug;13(3):298-319
references.pmid: 12152502
references.citation: Ann Intern Med. 2002 May 7;136(9):641-51
references.pmid: 11992299
references.citation: Ann Intern Med. 2009 Nov 17;151(10):727-37, W237-42
references.pmid: 19920273
references.citation: J Gen Intern Med. 2005 Jun;20(6):487-96
references.pmid: 15987322
references.citation: Obstet Gynecol. 2004 Apr;103(4):619-31
references.pmid: 15051550
references.citation: Radiology. 2005 Jan;234(1):79-85
references.pmid: 15618376
references.citation: Am J Prev Med. 2010 Jan;38(1):110-7
references.pmid: 20117566
references.citation: Nat Clin Pract Oncol. 2007 Nov;4(11):643-56
references.pmid: 17965642
references.citation: Can Assoc Radiol J. 2004 Jun;55(3):145-50
references.pmid: 15237774
references.citation: Med Care. 2008 Jul;46(7):692-700
references.pmid: 18580388
references.citation: Cancer. 2008 Feb 1;112(3):626-35
references.pmid: 18157831
references.citation: Evid Rep Technol Assess (Summ). 1999 Jan;(5):1-6
references.pmid: 11925972
references.citation: J Natl Cancer Inst. 2011 May 4;103(9):714-36
references.pmid: 21454908
references.citation: Prev Med. 1999 Apr;28(4):418-25
references.pmid: 10090871
references.citation: Obstet Gynecol. 2010 Nov;116(5):1158-70
references.pmid: 20966702
references.citation: J Natl Cancer Inst. 2010 Jan 20;102(2):82-8
references.pmid: 20056956
references.citation: J Community Health. 2011 Aug;36(4):675-83
references.pmid: 21267639
references.citation: J Clin Oncol. 2006 Mar 20;24(9):1357-62
references.pmid: 16549830