Cost effectiveness of shortening the screening interval or extending the age range of the NHS breast screening programme: computer simulation study.

Research output: Contribution to journalArticlepeer-review

Authors

  • Rob Boer
  • Harry De Koning
  • Anthony G Threlfall
  • Peter Warmerdeam
  • Andrew Street
  • And 2 others
  • Ellis Friedman
  • Ciaran Woodman

Colleges, School and Institutes

Abstract


Abstract

Objective : To compare the cost effectiveness of two possible modifications to the current UK screening programme: shortening the screening interval from three to two years and extending the age of invitation to a final screen from 64 to 69.

Design : Computer simulation model which first simulates life histories for women in the absence of a screening programme for breast cancer and then assesses how these life histories would be changed by introducing different screening policies. The model was informed by screening and cost data from the NHS breast screening programme.

Setting : North West region of England.

Main outcome measures : Numbers of deaths prevented, life years gained, and costs.

Results : Compared with the current breast screening programme both modifications would increase the number of deaths prevented and the number of life years saved. The current screening policy costs £2522 per life year gained; extending the age range of the programme would cost £2612 and shortening the interval £2709 per life year gained. The marginal cost per life year gained of extending the age range of the screening programme is £2990 and of shortening the screening interval is £3545.

Conclusions : If the budget for the NHS breast screening programme were to allow for two more invitations per woman, substantial mortality reductions would follow from extending the age range screened or reducing the screening interval. The difference between the two policies is so small that either could be chosen.


Key messages
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Computer modelling suggested that the current breast screening programme inNorth West England will reduce total female breast cancer mortality by 12.8%

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Extending the programme to age 69 would reduce mortality by 16.4% at a marginal cost per life year saved of £2990 while reducing the interval to two years would reduce mortality by 15.3% at a marginal cost per life year saved of £3545

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Extending the age range prevents more deaths from breast cancer but shortening the interval gains more life years

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If the budget for the NHS breast screening programme would allow for two more invitations per woman either of the two options could be chosen

Details

Original languageEnglish
Pages (from-to)376-379
JournalBritish Medical Journal
Volume317
Issue number7155
Publication statusPublished - 8 Aug 1998

Keywords

  • breast screening

ASJC Scopus subject areas