Budget impact analysis of breast cancer screening in Italy: The role of new technologies

Foglia, Emanuela; Marinelli, Sissi; Garagiola, Elisabetta; Ferrario, Lucrezia; Depretto, Catherine; Cartia, Francesco; Ferranti, Claudio; Porazzi, Emanuele; Scaperrotta, Gianfranco

doi:10.1177/0951484819870963

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…In order to evaluate the feasibility of implementing a new screening modality, it is essential to examine its economic consequences as well. A recent budget impact analysis about ABUS, conducted in Italy, found an increase in the screening phase expenditure, but economic advantage related to subsequent treatment of diagnosed patients ( 27 ). The program and the developed protocol for evaluation also provides an opportunity to examine the economic aspects of ABUS by taking local conditions and environment into account.…”

Section: Discussionmentioning

confidence: 99%

Development of a breast cancer screening protocol to use automated breast ultrasound in a local setting

Tittmann

Csanádi²,

Ágh³

et al. 2023

Front. Public Health

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IntroductionThe sensitivity of mammography screening is lower in women with dense breast. Increasing the efficacy of breast cancer screening have received special attention recently. The automated breast ultrasound (ABUS) shows promising results to complement mammography. Our aim was to expand the existing breast cancer screening protocol with ABUS within a Hungarian pilot project.MethodsFirst, we developed a protocol for the screening process focusing on integrating ABUS to the current practice. Consensus among clinical experts was achieved considering information from the literature and the actual opportunities of the hospital. Then we developed a protocol for evaluation that ensures systematic data collection and monitoring of screening with mammography and ABUS. We identified indicators based on international standards and adapted them to local setting. We considered their feasibility from the data source and timeframe perspective. The protocol was developed in a partnership of researchers, clinicians and hospital managers.ResultsThe process of screening activity was described in a detailed flowchart. Human and technological resource requirements and communication activities were defined. We listed 23 monitoring indicators to evaluate the screening program and checked the feasibility to calculate these indicators based on local data collection and other sources. Partnership between researchers experienced in planning and evaluating screening programs, interested clinicians, and hospital managers resulted in a locally implementable, evidence-based screening protocol.DiscussionThe experience and knowledge gained on the implementation of the ABUS technology could generate real-world data to support the decision on using the technology at national level.

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Section: Discussionmentioning

confidence: 99%

Development of a breast cancer screening protocol to use automated breast ultrasound in a local setting

Tittmann

Csanádi²,

Ágh³

et al. 2023

Front. Public Health

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show abstract

“…For costs of a screening mammogram, diagnosis and treatment by cancer stage we used previously reported estimates. [23][24][25] In order to increase screening adherence in Southern Italy (i.e. to overcome barrier 1), we considered an investment of 10 mobile screening units (at €180,000 each).…”

Section: Model Outcomes and Cost-effectiveness Analysesmentioning

confidence: 99%

Overcoming barriers: Modelling the effect of potential future changes of organized breast cancer screening in Italy

et al. 2023

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Objectives Organized breast cancer screening may not achieve its full potential due to organizational and cultural barriers. In Italy, two identified barriers were low attendance in Southern Italy and, in Italy as a whole, underscreening and overscreening in parts of the eligible population. The objective of this study was to identify potential changes to overcome these barriers and to quantify their costs and effects. Methods To assess the impact of potential measures to improve breast cancer screening in Italy, we performed an evaluation of costs and effects for increasing adherence for Southern Italy and harmonizing screening intervals (biennial screening) for the whole of Italy, using an online tool (EU-TOPIA evaluation tool) based on the MIcrosimulation SCreening ANalysis (MISCAN) model. Results Increasing adherence in Southern Italy through investing in mobile screening units has an acceptable cost-effectiveness ratio of €9531 per quality-adjusted life year gained. Harmonizing the screening interval by investing in measures to reduce opportunistic screening and simultaneously investing in mobile screening units to reduce underscreening is predicted to gain 1% fewer life-years, while saving 19% of total screening costs compared to the current situation. Conclusions Increasing adherence in Southern Italy and harmonizing the screening interval could result in substantial improvements at acceptable costs, or in the same benefits at lower costs. This example illustrates a systematic approach that can be easily applied to other European countries, as the online tools can be used by stakeholders to quantify effects and costs of a broad range of specific barriers, and ways to overcome them.

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“…Foglia et al [ 36 ] analyzed the budget impact of using ABUS in breast cancer screening. As screening pathways, they compared the AS-IS scenario (involving mammography, with the further examination if anything suspicious is detected), IDEAL scenario (mammography + HHUS), and TO-BE scenario (mammography + ABUS).…”

Section: Pros Regarding Abusmentioning

confidence: 99%

Pros and Cons for Automated Breast Ultrasound (ABUS): A Narrative Review

Boca

Ciurea

Ciortea³

et al. 2021

JPM

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Automated breast ultrasound (ABUS) is an ultrasound technique that tends to be increasingly used as a supplementary technique in the evaluation of patients with dense glandular breasts. Patients with dense breasts have an increased risk of developing breast cancer compared to patients with fatty breasts. Furthermore, for this group of patients, mammography has a low sensitivity in detecting breast cancers, especially if it is not associated with architectural distortion or calcifications. ABUS is a standardized examination with many advantages in both screening and diagnostic settings: it increases the detection rate of breast cancer, improves the workflow, and reduces the examination time. On the other hand, like any imaging technique, ABUS has disadvantages and even some limitations. Many disadvantages can be diminished by additional attention and training. Disadvantages regarding image acquisition are the inability to assess the axilla, the vascularization, and the elasticity of a lesion, while concerning the interpretation, the disadvantages are the artifacts due to poor positioning, lack of contact, motion or lesion related. This article reviews and discusses the indications, the advantages, and disadvantages of the method and also the sources of error in the ABUS examination.

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Budget impact analysis of breast cancer screening in Italy: The role of new technologies

Cited by 4 publications

References 23 publications

Development of a breast cancer screening protocol to use automated breast ultrasound in a local setting

Development of a breast cancer screening protocol to use automated breast ultrasound in a local setting

Overcoming barriers: Modelling the effect of potential future changes of organized breast cancer screening in Italy

Pros and Cons for Automated Breast Ultrasound (ABUS): A Narrative Review

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