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Estimating personal costs incurred by a woman participating in mammography screening in the National Breast and Cervical Cancer Early Detection Program
Author(s) -
Ekwueme Donatus U.,
Hall Ingrid J.,
Richardson Lisa C.,
Gardner James G.,
Royalty Janet,
Thompson Trevor D.
Publication year - 2008
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23613
Subject(s) - medicine , mammography , breast cancer , breast cancer screening , cost–benefit analysis , ethnic group , obstetrics , cost effectiveness , gynecology , demography , family medicine , cancer , risk analysis (engineering) , biology , ecology , sociology , anthropology
BACKGROUND. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) covers the direct clinical costs of breast and cervical cancer screening and diagnostic follow‐up for medically underserved, low‐income women. Personal costs are not covered. In this report, the authors estimated personal costs per woman participating in NBCCEDP mammography screening by race/ethnicity and also estimated lifetime personal costs (ages 50‐74 years). METHODS. A decision analysis model was constructed and parameterized by using empiric data from a retrospective cohort survey of mammography rescreening among women ages 50 years to 64 years who participated in the NBCCEDP. Data from 1870 women were collected from 1999 to 2000. The model simulated the flow of resources incurred by a woman participating in the NBCCEDP. The analysis was stratified by annual income into 2 scenarios: Scenario 1, <$10,000; and Scenario 2, from $10,000 to <$20,000. Sensitivity analyses were conducted to appraise uncertainty, and all costs were standardized to 2000 U.S. dollars. RESULTS. In Scenario 1, for all races/ethnicities, a woman incurred a 1‐time cost of $17 and a discounted lifetime cost of $108 for 10 screens and $262 for 25 screens; in Scenario 2, these amounts were $31 and from $197 to $475, respectively. In both scenarios, a non‐Hispanic white woman incurred the highest cost. The sensitivity analyses revealed that >70% of cost incurred was attributable to opportunity cost. CONCLUSIONS. Capturing and quantifying personal costs will help ascertain the total cost (ie, societal cost) of providing mammography screening to a medically underserved, low‐income woman participating in a publicly funded cancer screening program and, thus, will help determine the true cost‐effectiveness of such programs. Cancer 2008. Published 2008 by the American Cancer Society.