Abstract
Clinical breast examination (CBE) is recommended as a modality for breast cancer screening in Japan. Now, the nationwide introduction of screening mammography (SMG) is being considered, since intervention trials using SMG have shown an improved detection rate of early breast cancer and a lower false-negative rate.In this study, we performed a cost-effectiveness analysis of breast cancer screening with or without SMG.
The total net costs per patient for CBE with SMG would increase by 1.15-1.40 as compared with CBE alone. The number of years of life saved per woman for CBE with SMG would be 2. 15 times higher than for CBE alone. Thus, the cost-effectiveness ratio (the cost per life-year saved) for CBE with SMG would be approximately 75% of that for CBE alone.
In comparison with the cost-effectiveness ratio of other forms of cancer screening, colon examination would have the lowest cost-effectiveness ratio, followed by stomach, cervical, breast (CBE with SMG), breast (CBE alone) and lung examination.
We conclude that breast cancer screening combined with mammography would be preferable to clinical breast examination alone in terms of cost-effectiveness in Japan. Further investigations, including the screening interval and the targeted age group, are required to reduce the total net costs.
