Mammography screening not cost effective in younger women

1998 ◽  
Vol 144 (1) ◽  
pp. 8-8
Keyword(s):  
Mammography Screening ◽  
Cost Effective ◽  
Younger Women

scholarly journals Telemammography for breast cancer screening: a cost-effective approach in Argentina

2021 ◽  
Vol 28 (1) ◽  
pp. e100351
Author(s):  
Victoria Alba Malek Pascha ◽  
Li Sun ◽  
Ramiro Gilardino ◽  
Rosa Legood
Keyword(s):  
Breast Cancer ◽  
Sensitivity Analysis ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Probabilistic Sensitivity Analysis ◽  
Mammography Screening ◽  
Cost Effective ◽  
Access To Healthcare ◽  
Over 40 Years ◽  
Improve Access

ObjectivesArgentina is a low and middle-income country (LMIC) with a highly fragmented healthcare system that conflicts with access to healthcare stated by the country’s Universal Health Coverage plan. A tele-mammography network could improve access to breast cancer screening decreasing its mortality. This research aims to conduct an economic evaluation of the implementation of a tele-mammography program to improve access to healthcare.MethodsA cost-utility analysis was performed to explore the incremental benefit of annual tele-mammography screening for at-risk Argentinian women over 40 years old. A Markov model was developed to simulate annual mammography or tele-mammography screening in two hypothetical population-based cohorts of asymptomatic women. Parameter uncertainty was evaluated through deterministic and probabilistic sensitivity analysis. Model structure uncertainty was also explored to test the robustness of the results.ResultsIt was estimated that 31 out of 100 new cases of breast cancer would be detected by mammography and 39/100 by tele-mammography. The model returned an incremental cost-effectiveness ratio (ICER) of £26 051/quality-adjusted life-year (QALY) which is lower than the WHO-recommended threshold of £26 288/QALY for Argentina. Deterministic sensitivity analysis showed the ICER is most sensitive to the uptake and sensitivity of the screening tests. Probabilistic sensitivity analysis showed tele-mammography is cost-effective in 59% of simulations.DiscussionTele-mammography should be considered for adoption as it could improve access to expertise in underserved areas where adherence to screening protocols is poor. Disaggregated data by province is needed for a better- informed policy decision. Telemedicine could also be beneficial in ensuring the continuity of care when health systems are under stress like in the current COVID-19 pandemic.ConclusionThere is a 59% chance that tele-mammography is cost-effective compared to mammography for at-risk Argentinian women over 40- years old, and should be adopted to improve access to healthcare in underserved areas of the country.

scholarly journals Breast Thermograms Asymmetry Analysis using Gabor filters

2021 ◽  
Vol 309 ◽  
pp. 01109
Author(s):  
Priyanka Yadlapalli ◽  
Madhavi K Reddy ◽  
Sunitha Gurram ◽  
J Avanija ◽  
K Meenakshi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Cost Effective ◽  
Gabor Filters ◽  
Support Vector ◽  
Svm Classifier ◽  
Infrared Thermal Imaging ◽  
Younger Women ◽  
Early Diagnosis Of Cancer ◽  
Diagnosis Of Cancer

Women are far more likely than males to acquire breast cancer, and current research indicates that this is entirely avoidable. It is also to blame for higher death rates among younger women compared to older women in nearly all developing nations. Medical imaging modalities are continuously in need of development. A variety of medical techniques have been employed to detect breast cancer in women. The most recent studies support mammography for breast cancer screening, although its sensitivity and specificity remain suboptimal, particularly in individuals with thick breast tissue, such as young women. As a result, alternative modalities, such as thermography, are required. Digital Infrared Thermal Imaging (DITI), as it is known, detects and records temperature changes on the skin’s surface. Thermography is well-known for its non-invasive, painless, cost-effective, and high recovery rates, as well as its potential to identify breast cancer at an early stage. Gabor filters are used to extract the textural characteristics of the left and right breasts. Using a support vector machine, the thermograms are then classified as normal or malignant based on textural asymmetry between the breasts (SVM). The accuracy achieved by combining Gabor features with an SVM classifier is around 84.5 percent. The early diagnosis of cancer with thermography enhances the patient’s chances of survival significantly since it may detect the disease in its early stages.

scholarly journals Long-term Incidence and Mortality Trends for Breast Cancer in Germany

2020 ◽  
Vol 80 (06) ◽  
pp. 611-618
Author(s):  
Joachim Hübner ◽  
Alexander Katalinic ◽  
Annika Waldmann ◽  
Klaus Kraywinkel
Keyword(s):  
Breast Cancer ◽  
Older Women ◽  
Mammography Screening ◽  
Early Stage ◽  
West Germany ◽  
Mortality Trends ◽  
Younger Women ◽  
East And West Germany ◽  
Incidence And Mortality ◽  
East And West

Abstract Introduction Changes in risk factors and the introduction of mammography screening in 2005 have led to dramatic changes in the breast cancer-associated burden of disease in Germany. This study aimed to investigate long-term disease-related incidence and mortality trends in women from East and West Germany since the reunification of Germany. Methods Total and stage-specific incidence rates were evaluated based on data obtained from selected cancer registries. Sufficiently complete data going back to 1995 were available for 4 East German and 3 West German regions. The figures were weighted for population size, and rates were calculated for the whole of Germany based on the rates for East and West Germany. The study particularly focused on 3 different age groups: women eligible for mammography screening (50 – 69 years), younger women (30 – 49 years) and older women (70+ years). All rates were standardised for age. The mortality rates obtained from the official statistics on cause of death since 1990 were processed accordingly. Results Incidence rates in the observation period increased, as they were affected by the increasing number of cases with early-stage cancers being diagnosed in the screening age group. The total incidence for this group, which included the incidence of non-invasive breast cancers, increased by 14.5% between 2005 and 2016. Early-stage cancers (UICC stages 0 and I) increased by 48.1% while late-stage diagnoses (UICC stages III and IV) decreased by 31.6%. Qualitatively similar changes were noted for the other age groups, although they were less pronounced. The decrease in breast cancer mortality observed since the mid-1990s ended around 2008 for the group of younger women but continued in the screening age group. After 2008, an increase in mortality was observed in the group of older women. The differences in disease burden between East and West Germany (in favour of East Germany) decreased in younger women during the observation period but tended to increase in the group of older women. Conclusion The analysis suggests that the introduction of mammography screening contributed to a decrease in the incidence of advanced-stage breast cancers and in breast cancer-related mortality rates but also resulted in a substantial number of overdiagnoses. The relatively unfavourable incidence trend in the group of younger women, particularly in East Germany, should be interpreted in the context of lifestyle changes. The slight increase in mortality observed in the group of older women after 2008 requires further analysis.

Abstract P6-02-09: Bahcesehir mammography screening project (BMSP) is cost-effective in a developing country

2016 ◽  
Author(s):  
V Ozmen ◽  
N Cabiogsu ◽  
S Ozkan-Gurdal ◽  
N Ozaydin ◽  
A Kayhan ◽  
...  
Keyword(s):  
Developing Country ◽  
Mammography Screening ◽  
Cost Effective

scholarly journals Benefits and harms of annual, biennial, or triennial breast cancer mammography screening for women at average risk of breast cancer: a systematic review for the European Commission Initiative on Breast Cancer (ECIBC)

2021 ◽  
Author(s):  
Carlos Canelo-Aybar ◽  
Margarita Posso ◽  
Nadia Montero ◽  
Ivan Solà ◽  
Zuleika Saz-Parkinson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
European Commission ◽  
False Positive ◽  
Mammography Screening ◽  
Cochrane Library ◽  
Average Risk ◽  
Age Group ◽  
Younger Women ◽  
Modelling Studies ◽  
Screening Intervals

Abstract Background Although mammography screening is recommended in most European countries, the balance between the benefits and harms of different screening intervals is still a matter of debate. This review informed the European Commission Initiative on Breast Cancer (BC) recommendations. Methods We searched PubMed, EMBASE, and the Cochrane Library to identify RCTs, observational or modelling studies, comparing desirable (BC deaths averted, QALYs, BC stage, interval cancer) and undesirable (overdiagnosis, false positive related, radiation related) effects from annual, biennial, or triennial mammography screening in women of average risk for BC. We assessed the certainty of the evidence using the GRADE approach. Results We included one RCT, 13 observational, and 11 modelling studies. In women 50–69, annual compared to biennial screening may have small additional benefits but an important increase in false positive results; triennial compared to biennial screening may have smaller benefits while avoiding some harms. In younger women (aged 45–49), annual compared to biennial screening had a smaller gain in benefits and larger harms, showing a less favourable balance in this age group than in women 50–69. In women 70–74, there were fewer additional harms and similar benefits with shorter screening intervals. The overall certainty of the evidence for each of these comparisons was very low. Conclusions In women of average BC risk, screening intervals have different trade-offs for each age group. The balance probably favours biennial screening in women 50–69. In younger women, annual screening may have a less favourable balance, while in women aged 70–74 years longer screening intervals may be more favourable.

THE HEALTH ECONOMICS OF CALCIUM AND VITAMIN D3 FOR THE PREVENTION OF OSTEOPOROTIC HIP FRACTURES IN SWEDEN

2002 ◽  
Vol 18 (4) ◽  
pp. 791-807 ◽  
Author(s):  
Michael S. Willis
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Cost Saving ◽  
Older Women ◽  
Hip Fractures ◽  
Cost Effective ◽  
Younger Women ◽  
History Of ◽  
Simulation Results ◽  
The Cost

Objective: The objective of this study was to examine the economics of administering calcium and vitamin D3 to post-menopausal women in Sweden. We focus primarily on the cost-effectiveness of treating older women for whom clear evidence of efficacy is available. We supplement this information, however, with estimates of the cost-effectiveness of treating certain high-risk groups of younger women, while acknowledging the greater uncertainty involved.Methods: We developed a Markov model for analyzing the occurrence and timing of hip fractures, based almost entirely on peer-reviewed data from Sweden. In a 3-year randomized clinical trial, the combination of calcium and vitamin D3 was shown to reduce the risk of hip fractures by 27%. Costs for treating hip fractures were based on 1,080 women who were hospitalized in Stockholm.Results: Treatment of 70-year-old women was cost saving at efficacy as low as two-thirds that seen in the clinical trials, and upwards. Even at modest rates of efficacy, treatment of the high-risk 50- and 60-year-old cohorts was generally cost-effective and in some cases even cost saving. Particularly cost-effective was treatment of women with identified osteoporosis or a maternal family history of hip fracture.Conclusion: Simulation results suggest a role for lifetime treatment of older women with calcium and vitamin D3 in Sweden. While there is more uncertainty underlying the treatment of younger women, our simulation results suggest that treatment may also be cost saving or at least cost-effective for many cohorts of high-risk 50- and particularly 60-year-old women, in particular those with osteoporosis or a maternal family history of hip fracture.

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