From the Guidelines
The cost per year of life saved for screening mammograms is approximately $20,000 to $50,000, which is considered acceptable within healthcare economics. This estimate is based on the most recent and highest quality study available, which highlights the importance of screening mammography in reducing breast cancer mortality and morbidity 1.
Key Points
- The cost-effectiveness of screening mammograms varies depending on the population being screened and the methodology used, with estimates ranging from $20,000 to $50,000 per year of life saved.
- For women aged 50-74, biennial screening mammography tends to be more cost-effective than annual screening, with a better balance between the benefits of early cancer detection and the expenses of screening programs 1.
- The cost-effectiveness of screening mammography improves in higher-risk populations, where the benefits of early detection and treatment are more pronounced.
- The wide variation in estimates stems from different assumptions about screening frequency, compliance rates, treatment costs, and how life-years are valued, but most analyses conclude that mammography screening falls within acceptable cost-effectiveness thresholds for preventive health interventions 1.
Considerations
- The benefits of screening mammography, including reduced breast cancer mortality and morbidity, must be weighed against the potential risks, such as false-positive recalls and biopsies, overdiagnosis, and patient anxiety 1.
- Screening recommendations should be based on life expectancy and competing comorbidities, rather than age alone, to ensure that women continue to benefit from screening mammography as long as they remain in overall good health and are willing to undergo the examination and subsequent testing or biopsy, if an abnormality is identified 1.
From the Research
Cost Per Year of Life Saved for Screening Mammograms
- The cost per year of life saved for screening mammograms is a crucial factor in evaluating the cost-effectiveness of breast cancer screening programs 2, 3, 4, 5, 6.
- According to a study published in Radiology in 1994, the marginal cost per year of life saved for screening mammography in women aged 40-49 years was comparable to that of other generally accepted medical procedures, assuming a mortality reduction of 15% or greater 2.
- Another study published in Obstetrics and Gynecology Clinics of North America in 2011 estimated that the cost per year of life saved for screening mammography was well within the range for other commonly accepted medical interventions 3.
- A systematic review published in the Iranian Journal of Public Health in 2013 found that the cost per life year gained for breast cancer screening using mammography ranged from $1,634 to $65,000, depending on the age group and screening interval 5.
- The review also found that biennial screening for women aged 50-70 years was the most cost-effective option, with a cost per life year gained of $2,685 5.
- A study published in the Journal of Medical Screening in 2014 evaluated the cost-effectiveness of annual versus biennial screening mammography for women with high mammographic breast density and found that annual screening generated an additional 0.0014 quality-adjusted life years (QALYs) at a cost of $819 per patient, resulting in an incremental cost-effectiveness ratio of $565,912/QALY 6.