Cargando…
Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province
To evaluate the implementations of Cancer Screening Program in Urban Hebei and to model the cost-effectiveness of a risk-based breast Cancer Screening Program. Women aged 40–74 years were invited to participate the Cancer Screening Program in Urban Hebei form 2016 to 2020 by completing questionnaire...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9971026/ https://www.ncbi.nlm.nih.gov/pubmed/36849794 http://dx.doi.org/10.1038/s41598-023-29985-z |
_version_ | 1784898021511659520 |
---|---|
author | Shi, Jin Guan, Yazhe Liang, Di Li, Daojuan He, Yutong Liu, Yunjiang |
author_facet | Shi, Jin Guan, Yazhe Liang, Di Li, Daojuan He, Yutong Liu, Yunjiang |
author_sort | Shi, Jin |
collection | PubMed |
description | To evaluate the implementations of Cancer Screening Program in Urban Hebei and to model the cost-effectiveness of a risk-based breast Cancer Screening Program. Women aged 40–74 years were invited to participate the Cancer Screening Program in Urban Hebei form 2016 to 2020 by completing questionnaires to collect information about breast cancer exposure. Clinical screening including ultrasound and mammography examination were performed. We developed a Markov model to estimate the lifetime costs and benefits, in terms of quality-adjusted life years (QALY), of a high-risk breast Cancer Screening Program. Nine screening strategies and no screening were included in the study. The age-specific incidence, transition probability data and lifetime treatment costs were derived and adopted from other researches. Average cost-effectiveness ratios (ACERs) were estimated as the ratios of the additional costs of the screening strategies to the QLYG compared to no screening. Incremental cost-effectiveness ratios (ICERs) were calculated based on the comparison of a lower cost strategies to the next more expensive and effective strategies after excluding dominated strategies and extendedly dominated strategies. ICERs were used to compare with a willingness-to-pay (WTP) threshold. Sensitivity analysis was explored the influence factors. A total of 84,029 women completed a risk assessment questionnaire, from which 20,655 high-risk breast cancer females were evaluated, with a high-risk rate of 24.58%. There were 13,392 high-risk females completed the screening program, with participation rate was 64.84%. Undergoing ultrasound, mammography and combined screening, the suspicious positive detection rates were 15.00%, 9.20% and 19.30%, and the positive detection rates were 2.11%, 2.76% and 3.83%, respectively. According to the results by Markov model, at the end of 45 cycle, the early diagnosis rates were 55.53%, 60.68% and 62.47% underwent the annual screening by ultrasound, mammography and combined, the proportion of advanced cancer were 17.20%, 15.85% and 15.36%, respectively. Different screening method and interval yield varied. In the exploration of various scenarios, annual ultrasound screening is the most cost-effective strategy with the ICER of ¥116,176.15/QALY. Sensitivity analyses demonstrated that the results are robust. Although it was not cost effective, combined ultrasound and mammography screening was an effective strategy for higher positive detection rate of breast cancer. High-risk population-based breast cancer screening by ultrasound annually was the most cost-effective strategy in Urban Hebei Province. |
format | Online Article Text |
id | pubmed-9971026 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-99710262023-03-01 Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province Shi, Jin Guan, Yazhe Liang, Di Li, Daojuan He, Yutong Liu, Yunjiang Sci Rep Article To evaluate the implementations of Cancer Screening Program in Urban Hebei and to model the cost-effectiveness of a risk-based breast Cancer Screening Program. Women aged 40–74 years were invited to participate the Cancer Screening Program in Urban Hebei form 2016 to 2020 by completing questionnaires to collect information about breast cancer exposure. Clinical screening including ultrasound and mammography examination were performed. We developed a Markov model to estimate the lifetime costs and benefits, in terms of quality-adjusted life years (QALY), of a high-risk breast Cancer Screening Program. Nine screening strategies and no screening were included in the study. The age-specific incidence, transition probability data and lifetime treatment costs were derived and adopted from other researches. Average cost-effectiveness ratios (ACERs) were estimated as the ratios of the additional costs of the screening strategies to the QLYG compared to no screening. Incremental cost-effectiveness ratios (ICERs) were calculated based on the comparison of a lower cost strategies to the next more expensive and effective strategies after excluding dominated strategies and extendedly dominated strategies. ICERs were used to compare with a willingness-to-pay (WTP) threshold. Sensitivity analysis was explored the influence factors. A total of 84,029 women completed a risk assessment questionnaire, from which 20,655 high-risk breast cancer females were evaluated, with a high-risk rate of 24.58%. There were 13,392 high-risk females completed the screening program, with participation rate was 64.84%. Undergoing ultrasound, mammography and combined screening, the suspicious positive detection rates were 15.00%, 9.20% and 19.30%, and the positive detection rates were 2.11%, 2.76% and 3.83%, respectively. According to the results by Markov model, at the end of 45 cycle, the early diagnosis rates were 55.53%, 60.68% and 62.47% underwent the annual screening by ultrasound, mammography and combined, the proportion of advanced cancer were 17.20%, 15.85% and 15.36%, respectively. Different screening method and interval yield varied. In the exploration of various scenarios, annual ultrasound screening is the most cost-effective strategy with the ICER of ¥116,176.15/QALY. Sensitivity analyses demonstrated that the results are robust. Although it was not cost effective, combined ultrasound and mammography screening was an effective strategy for higher positive detection rate of breast cancer. High-risk population-based breast cancer screening by ultrasound annually was the most cost-effective strategy in Urban Hebei Province. Nature Publishing Group UK 2023-02-27 /pmc/articles/PMC9971026/ /pubmed/36849794 http://dx.doi.org/10.1038/s41598-023-29985-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Shi, Jin Guan, Yazhe Liang, Di Li, Daojuan He, Yutong Liu, Yunjiang Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province |
title | Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province |
title_full | Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province |
title_fullStr | Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province |
title_full_unstemmed | Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province |
title_short | Cost-effectiveness evaluation of risk-based breast cancer screening in Urban Hebei Province |
title_sort | cost-effectiveness evaluation of risk-based breast cancer screening in urban hebei province |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9971026/ https://www.ncbi.nlm.nih.gov/pubmed/36849794 http://dx.doi.org/10.1038/s41598-023-29985-z |
work_keys_str_mv | AT shijin costeffectivenessevaluationofriskbasedbreastcancerscreeninginurbanhebeiprovince AT guanyazhe costeffectivenessevaluationofriskbasedbreastcancerscreeninginurbanhebeiprovince AT liangdi costeffectivenessevaluationofriskbasedbreastcancerscreeninginurbanhebeiprovince AT lidaojuan costeffectivenessevaluationofriskbasedbreastcancerscreeninginurbanhebeiprovince AT heyutong costeffectivenessevaluationofriskbasedbreastcancerscreeninginurbanhebeiprovince AT liuyunjiang costeffectivenessevaluationofriskbasedbreastcancerscreeninginurbanhebeiprovince |