Author, as appears in the article.: Misericòrdia Carles; Margarita Posso; Montserrat Rué; Teresa Puig; Xavier Bonfill
Department: Economia
URV's Author/s: Carles , Misericòrdia; Posso, Margarita; Rué, Montserrat; Puig, Teresa; Bonfill, Xavier
Keywords: Càncer de mamella Anàlisi de cost-efectivitat Mamografia Cancer de mama Análisis de coste-efectividad Mamografía Breast cancer Cost-effectiveness analysis Mammography
Abstract: Objectives: The usual practice in breast cancer screening programmes for mammogram interpretation is to perform double reading. However, little is known about its cost-effectiveness in the context of digital mammography. Our purpose was to evaluate the cost-effectiveness of double reading versus single reading of digital mammograms in a population-based breast cancer screening programme. Methods: Data from 28,636 screened women was used to establish a decision-tree model and to compare three strategies: 1) double reading; 2) double reading for women in their first participation and single reading for women in their subsequent participations; and 3) single reading. We calculated the incremental cost-effectiveness ratio (ICER), which was defined as the expected cost per one additionally detected cancer. We performed a deterministic sensitivity analysis to test the robustness of the ICER. Results: The detection rate of double reading (5.17‰) was similar to that of single reading (4.78‰; P = .768). The mean cost of each detected cancer was €8,912 for double reading and €8,287 for single reading. The ICER of double reading versus single reading was €16,684. The sensitivity analysis showed variations in the ICER according to the sensitivity of reading strategies. The strategy that combines double reading in first participation with single reading in subsequent participations was ruled out due to extended dominance. Conclusions: From our results, double reading appears not to be a cost-effective strategy in the context of digital mammography. Double reading would eventually be challenged in screening programmes, as single reading might entail important net savings without significantly changing the cancer detection rate. These results are not conclusive and should be confirmed in prospective studies that investigate long-term outcomes like quality adjusted life years (QALYs).
Research group: Grup de Recerca en Anàlisi Econòmica i Salut
Thematic Areas: Economia i empresa Economía y empresa Economics and business
licence for use: https://creativecommons.org/licenses/by/3.0/es/
ISSN: 1932-6203
Author identifier: 0000-0003-3796-3014; N/A; N/A; N/A; N/A
Record's date: 2016-09-14
Journal volume: 11
Papper version: info:eu-repo/semantics/publishedVersion
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Entity: Universitat Rovira i Virgili
Journal publication year: 2016
First page: Art.num. e0159806
Publication Type: Article Artículo Article
Repositori URV