KeepHealthCare.ORG – How risk-based breast cancer screening could cut costs, reduce overdiagnosis
Breast cancer screening programs could reduce both costs and overdiagnosis by focusing on at-risk women, according to a new study published by JAMA Oncology.
“Identifying risk-stratified screening strategies with a more favorable ratio of overdiagnoses to breast cancer deaths prevented would improve the quality of life of women and save resources,” wrote author Nora Pashayan, MD, PhD, of University College London, and colleagues.
The authors examined a hypothetical patient cohort of 364,500 50-year-old women who underwent follow-up screening until the age of 85. They compared the impact of three models: one that included no screening, one that included age-based screening and one that included risk-stratified screening, offering certain at-risk women screening every three years until the age of 69.
Overall, as the risk-stratified model’s risk threshold became lower, the cost of the program grew larger. But when the model used a risk threshold of the 35th percentile, it resulted in no additional quality-adjusted life-years (QALYs) gained. The risk-stratified model, using a risk threshold of the 70th percentile, had the highest net monetary benefit (NMB) with a 72-percent probability of being cost-effective.