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assessment of the benefits and cost-effectiveness of population-based breast cancer screening in urban china: a model-based analysis
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نویسنده
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wang jing ,greuter marcel j.w. ,zheng senshuang ,van veldhuizen daniëlle w.a. ,vermeulen karin m. ,wang yuan ,lu wenli ,de bock geertruida h.
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منبع
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international journal of health policy and management - 2022 - دوره : 11 - شماره : 9 - صفحه:1658 -1667
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چکیده
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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.
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کلیدواژه
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breast neoplasms ,mammography ,mass screening ,cost-benefit analysis ,urban china
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آدرس
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university of groningen, university medical center groningen, department of epidemiology, netherlands, university of groningen, university medical center groningen, department of radiology, netherlands. university of twente, faculty of electrical engineering mathematics and computer science, technical medical centre, robotics and mechatronics (ram) group, netherlands, university of groningen, university medical center groningen, department of epidemiology, netherlands, university of groningen, university medical center groningen, department of epidemiology, netherlands, university of groningen, university medical center groningen, department of epidemiology, netherlands, tianjin medical university, collaborative innovation center of chronic disease prevention and control, school of public health, department of epidemiology and health statistics, china, tianjin medical university, collaborative innovation center of chronic disease prevention and control, school of public health, department of epidemiology and health statistics, china, university of groningen, university medical center groningen, department of epidemiology, netherlands
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پست الکترونیکی
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g.h.de.bock@umcg.nl
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Authors
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