The Cost-Effectiveness of Mammography-Based Breast Cancer Screening in Canada A Systematic Review

Main Article Content

Talha Tahir https://orcid.org/0000-0003-1018-3704
Melanie Mitsui Wong https://orcid.org/0000-0001-6963-6339
Rabia Tahir
Michael Mitsui Wong

female breast cancer screening, cost effectiveness, quality of life

Abstract

Background: The current literature on female breast cancer screening is largely focused on the health out-comes that result from screening. There is comparatively little data on the cost-effectiveness of the screening.


Methods: This systematic review sought to identify all studies published within the last 10 years that analyzed the cost-effectiveness of mammography-based female breast cancer screening policies in Canada.


Results: Seven studies were included, and four were applicable to the average-risk Canadian women. Triennial screening for average-risk women aged 50–69 years was the most cost-effective in terms of cost per QALY. The use of MRI with mammography for women with the BRCA1/2 mutation was cost-effective, while annual mammography-based screening for women with dense breasts was cost-ineffective.


Conclusion: Analyses of the cost-effectiveness of mammography-based screening within Canadian populations are few in numbers and have heterogeneous methodologies. The existing data suggest that Canada’s current screening policy to screen average-risk women aged 50–74 years, biennially or triennially is cost-effective.


Résumé
Contexte : La documentation actuelle sur le dépistage du cancer du sein chez la femme est principalement axée sur les résultats cliniques qui découlent du dépistage. Il existe relativement peu de données sur le rapport coût/efficacité du dépistage.



Méthodologie  : Cette revue systématique a tenté de repérer toutes les études publiées au cours des dix dernières années qui ont analysé la rentabilité des politiques de dépistage du cancer du sein par mammogra-phie chez la femme au Canada.


Résultats : Sept études ont été retenues, et quatre d’entre elles s’appliquent aux femmes canadiennes à risque moyen. Le dépistage triennal chez les femmes à risque moyen âgées de 50 à 69 ans est le plus rentable en ce qui concerne le coût par AVAQ. L’utilisation de l’IRM couplée à la mammographie chez les femmes présentant la mutation BRCA1/2 est rentable, tandis que le dépistage annuel par mammographie chez les femmes aux seins denses ne l’est pas.


Conclusion : Les analyses du rapport coût/efficacité du dépistage par mammographie au sein des populations canadiennes sont peu nombreuses et leurs méthodologies sont hétérogènes. D’après les données existantes, la politique actuelle du Canada en matière de dépistage, qui consiste à faire subir une mammographie de dépi-stage aux femmes à risque moyen âgées de 50 à 74 ans tous les deux ou trois ans, est rentable.

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