Cargando…
Assessment of the Benefits and Cost-Effectiveness of Population-Based Breast Cancer Screening in Urban China: A Model-Based Analysis
Background: To decrease the burden of breast cancer (BC), the Chinese government recently introduced biennial mammography screening for women aged 45-70 years. In this study, we assess the effectiveness and cost-effectiveness of implementing this programme in urban China using a micro-simulation mod...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kerman University of Medical Sciences
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808213/ https://www.ncbi.nlm.nih.gov/pubmed/34273933 http://dx.doi.org/10.34172/ijhpm.2021.62 |
_version_ | 1784862889596682240 |
---|---|
author | Wang, Jing Greuter, Marcel J.W. Zheng, Senshuang van Veldhuizen, Daniëlle W.A. Vermeulen, Karin M. Wang, Yuan Lu, Wenli de Bock, Geertruida H. |
author_facet | Wang, Jing Greuter, Marcel J.W. Zheng, Senshuang van Veldhuizen, Daniëlle W.A. Vermeulen, Karin M. Wang, Yuan Lu, Wenli de Bock, Geertruida H. |
author_sort | Wang, Jing |
collection | PubMed |
description | Background: To decrease the burden of breast cancer (BC), the Chinese government recently introduced biennial mammography screening for women aged 45-70 years. In this study, we assess the effectiveness and cost-effectiveness of implementing this programme in urban China using a micro-simulation model. Methods: The ‘Simulation Model on radiation Risk and breast cancer Screening’ (SiMRiSc) was applied, with parameters updated based on available data for the Chinese population. The base scenario was biennial mammography screening for women aged 45-70 years, and this was compared to a reference population with no screening. Seven alternative scenarios were then simulated by varying the screening intervals and participant ages. This analysis was conducted from a societal perspective. The discounted incremental cost-effectiveness ratio (ICER) was compared to a threshold of triple the gross domestic product (GDP) per life years gained (LYG), which was 30 785 USD/LYG. Univariate sensitivity analyses were conducted to evaluate model robustness. In addition, a budget impact analysis was performed by comparing biennial screening with no screening at a time horizon of 10 years. Results: Compared with no screening, the base scenario was cost-effective in urban China, giving a discounted average cost-effectiveness ratio (ACER) of 17 309 USD/LYG. The model was most sensitive to the cost of mammography per screen, followed by mean size of self-detected tumours, mammographic breast density and the cumulative lifetime risk of BC. The efficient frontier showed that at a threshold of 30 785 USD/LYG, the base scenario was the optimal scenario with a discounted ICER of 25 261 USD/LYG. Over 10 years, screening would incur a net cost of almost 38.1 million USD for a city with 1 million citizens. Conclusion: Compared to no screening, biennial mammography screening for women aged from 45-70 is cost-effective in urban China. |
format | Online Article Text |
id | pubmed-9808213 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Kerman University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-98082132023-01-10 Assessment of the Benefits and Cost-Effectiveness of Population-Based Breast Cancer Screening in Urban China: A Model-Based Analysis Wang, Jing Greuter, Marcel J.W. Zheng, Senshuang van Veldhuizen, Daniëlle W.A. Vermeulen, Karin M. Wang, Yuan Lu, Wenli de Bock, Geertruida H. Int J Health Policy Manag Original Article Background: To decrease the burden of breast cancer (BC), the Chinese government recently introduced biennial mammography screening for women aged 45-70 years. In this study, we assess the effectiveness and cost-effectiveness of implementing this programme in urban China using a micro-simulation model. Methods: The ‘Simulation Model on radiation Risk and breast cancer Screening’ (SiMRiSc) was applied, with parameters updated based on available data for the Chinese population. The base scenario was biennial mammography screening for women aged 45-70 years, and this was compared to a reference population with no screening. Seven alternative scenarios were then simulated by varying the screening intervals and participant ages. This analysis was conducted from a societal perspective. The discounted incremental cost-effectiveness ratio (ICER) was compared to a threshold of triple the gross domestic product (GDP) per life years gained (LYG), which was 30 785 USD/LYG. Univariate sensitivity analyses were conducted to evaluate model robustness. In addition, a budget impact analysis was performed by comparing biennial screening with no screening at a time horizon of 10 years. Results: Compared with no screening, the base scenario was cost-effective in urban China, giving a discounted average cost-effectiveness ratio (ACER) of 17 309 USD/LYG. The model was most sensitive to the cost of mammography per screen, followed by mean size of self-detected tumours, mammographic breast density and the cumulative lifetime risk of BC. The efficient frontier showed that at a threshold of 30 785 USD/LYG, the base scenario was the optimal scenario with a discounted ICER of 25 261 USD/LYG. Over 10 years, screening would incur a net cost of almost 38.1 million USD for a city with 1 million citizens. Conclusion: Compared to no screening, biennial mammography screening for women aged from 45-70 is cost-effective in urban China. Kerman University of Medical Sciences 2021-07-04 /pmc/articles/PMC9808213/ /pubmed/34273933 http://dx.doi.org/10.34172/ijhpm.2021.62 Text en © 2022 The Author(s); Published by Kerman University of Medical Sciences https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Wang, Jing Greuter, Marcel J.W. Zheng, Senshuang van Veldhuizen, Daniëlle W.A. Vermeulen, Karin M. Wang, Yuan Lu, Wenli de Bock, Geertruida H. Assessment of the Benefits and Cost-Effectiveness of Population-Based Breast Cancer Screening in Urban China: A Model-Based Analysis |
title | Assessment of the Benefits and Cost-Effectiveness of Population-Based Breast Cancer Screening in Urban China: A Model-Based Analysis |
title_full | Assessment of the Benefits and Cost-Effectiveness of Population-Based Breast Cancer Screening in Urban China: A Model-Based Analysis |
title_fullStr | Assessment of the Benefits and Cost-Effectiveness of Population-Based Breast Cancer Screening in Urban China: A Model-Based Analysis |
title_full_unstemmed | Assessment of the Benefits and Cost-Effectiveness of Population-Based Breast Cancer Screening in Urban China: A Model-Based Analysis |
title_short | Assessment of the Benefits and Cost-Effectiveness of Population-Based Breast Cancer Screening in Urban China: A Model-Based Analysis |
title_sort | assessment of the benefits and cost-effectiveness of population-based breast cancer screening in urban china: a model-based analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808213/ https://www.ncbi.nlm.nih.gov/pubmed/34273933 http://dx.doi.org/10.34172/ijhpm.2021.62 |
work_keys_str_mv | AT wangjing assessmentofthebenefitsandcosteffectivenessofpopulationbasedbreastcancerscreeninginurbanchinaamodelbasedanalysis AT greutermarceljw assessmentofthebenefitsandcosteffectivenessofpopulationbasedbreastcancerscreeninginurbanchinaamodelbasedanalysis AT zhengsenshuang assessmentofthebenefitsandcosteffectivenessofpopulationbasedbreastcancerscreeninginurbanchinaamodelbasedanalysis AT vanveldhuizendaniellewa assessmentofthebenefitsandcosteffectivenessofpopulationbasedbreastcancerscreeninginurbanchinaamodelbasedanalysis AT vermeulenkarinm assessmentofthebenefitsandcosteffectivenessofpopulationbasedbreastcancerscreeninginurbanchinaamodelbasedanalysis AT wangyuan assessmentofthebenefitsandcosteffectivenessofpopulationbasedbreastcancerscreeninginurbanchinaamodelbasedanalysis AT luwenli assessmentofthebenefitsandcosteffectivenessofpopulationbasedbreastcancerscreeninginurbanchinaamodelbasedanalysis AT debockgeertruidah assessmentofthebenefitsandcosteffectivenessofpopulationbasedbreastcancerscreeninginurbanchinaamodelbasedanalysis |