Economic evaluation of a mammography-based breast cancer screening programme in Spain

The aim of the study was to perform a cost-effectiveness analysisof a breast cancer (BC) mammography screening programme, comparedto a do-nothing alternative, In Spain. Screening consisted ofa biennial mammography performed on all women 50–65 yearsold. A marginal analysis including women 45–49 years oldwas also performed. With the aid of a decision tree model, thenumbers of BC cases diagnosed through screening, BC cases missedby screening and false-positive BC cases were calculated. Costswere calculated by feeding local data into Markovian modelsand the cost-effectiveness ratio calculation was performed ina computer spread sheet. A sensitivity analysis was also conducted.Results were presented in ECUs of 1993. The cost-effectivenessratio per avoided death is 115,500 ECUs and per saved life year7,300 ECUs. Including women 45–49 years old in the programmeraises this ratio to 229,000 and 9,400 ECUs respectively. Thesensitivity analysis showed the efficacy of mammography, complianceof the programme and screening costs to be the more sensitivevariables.