Cost-effectiveness Analysis of Breast Cancer Screening for Japanese Women Using Mammography and Physical Examination

• Published in: Journal of Japan Association of Breast Cancer Screening Vol. 4; no. 1; pp. 49 - 57
• Main Authors: Iinuma, Takeshi, Matsumoto, Tohru, Kido, Choichiro
• Format: Journal Article
• Language: Japanese
• Published: Japan Association of Breast Cancer Screening 1995
• Subjects: breast cancer; cost-effectiveness analysis; Japanese women; mammography; mass screening
• ISSN: 0918-0729; 1882-6873
• DOI: 10.3804/jjabcs.4.49

In Japan, mass screening for breast cancer in women employs physical breast examination, although its efficacy seems not to be adequate. The Ministry of Health and Welfare of the Japanese Government is considering the introduction of mammography for mass screening. In our previous report, we have shown that the risk of radiation exposure by mammography is equal to the benefit of breast cancer screening at the age of 30 and becomes much smaller as the age of screenee increases. This report describes the cost-effectiveness analysis of breast cancer screening when mammography is adopted together with physical examination as a screening method. A mathematical model was used to calculate the effectiveness of the screening in terms of person-years saved from breast cancer, the cost of the screening examination, and details of the examination as well as the therapeutic expenditure for screening-detected patients and outpatients. Finally, the cost-effectiveness ratio was estimated by dividing the cost of screening with person-year saved as a function of screenee age (Japanese women). Various numerical data to be introduced into the mathematical model were obtained from a consensus panel of seven specialists in a research group on breast cancer screening under one of the authors (Dr. C. Kido). The cost of one person-year saved depends greatly on the age of the screenee, but it is lowest at the age of 4549 years old, being 2.5×106 yen/person-year. However, this value is about 3times higher than those calculated for stomach and colorectal cancer screenings in Japan. Further investigation is needed to establish more accurate data for cost-effectiveness analysis using several model fields of breast cancer screening.