Is Mammography for Breast Cancer Screening Cost-Effective in Both Western and Asian Countries?: Results of a Systematic Review

Abstract

Background: Mammography is considered the gold standard of breast cancer mass screening and many countries have implemented this as an established breast cancer screening strategy. However, although the incidence of breast cancer and racial characteristics are different between Western and Asian countries, many Asian countries adopted mammography for mass screening. Therefore, the objective of this research was to determine whether mammography mass screening is cost-effective for both Western and Asian countries. Materials and Methods: A systematic review was performed of 17 national mammography cost-effectiveness data sets. Per capita gross domestic product (GDP), breast cancer incidence rate, and the most optimal costeffectiveness results [cost per life year saved (LYS)] of a mammography screening strategy for each data set were extracted. The CE/per capita GDP ratio is used to compare the cost-effectiveness of mammography by rate boundary line determining whether mammography screening is cost-effective or not. Results: We found that the cost-effective cut-off point of breast cancer incidence rate was 45.04; it exactly divided countries into Western and Asian countries (p<0.0014). Conclusions: Mammography screening is cost-effective in most of Western countries, but not in Asian countries. The reason for this result may be the issues of incidence rate or racial characteristics, such as dense breast tissue. The results indicate that mammography screening should be adopted prudently in Asian countries and other countries with low incidence rates.

Comparison of Automated Breast Volume Scanning and Hand-Held Ultrasound in the Detection of Breast Cancer: an Analysis of 5,566 Patient Evaluations

“…Moreover, as Asian women have smaller breast volumes and less body fat, resulting in relatively dense breasts, it can be relatively difficult to detect breast cancer by mammography alone (Yoo et al, 2013). For these reasons, a supplemental screening tool in addition to mammography is needed to improve the detection of breast cancer among Asian women and more generally (Boonlikit, 2013;Suh et al, 2013).…”

“…In Korea, mammography is implemented for breast cancer screening with controversy in cost-effectiveness (Kang et al, 2013;Yoo et al, 2013). Mammography has well recognized limitations, such as reduced sensitivity of both screening and diagnostic mammography in dense breast tissue by as much as 50% compared with fatty breast tissue (Kolb et al, 2002;Berg et al, 2004;Boyd et al, 2007).…”

Societal costs and effects of implementing population-based mammography screening in Greenland

“…In contrast, the most favourable option found in this paper was regional screening with accommodation in regular hotels, which encompassed 0.5 million DKK (67,500 Euro)/YLS and 3.9 million DKK (0,53 million Euro)/QALY gained. A systematic review of 17 national data sets found mammography screening cost-effective in western countries, while not in most Asian countries [27]. The authors concluded it was because of the low breast cancer incidence and ethnic characteristics in Asia [27].…”

“…A systematic review of 17 national data sets found mammography screening cost-effective in western countries, while not in most Asian countries [27]. The authors concluded it was because of the low breast cancer incidence and ethnic characteristics in Asia [27]. The inhabitants of Greenland originate from Asia [4], which can explain the low incidence rate.…”

Validation of Electrical Impedance Tomography Qualitative and Quantitative Values and Comparison of the Numeric Pain Distress Score against Mammography

“…Early diagnosis has been the major factor in the reduction of mortality and breast cancer management costs (Elmore et al, 2005;Ki-Bong Yoo et al, 2013). BSE and CBE are both non-standard and not the ideal breast cancer screening as by the time a cancer is able to be detected via CBE, it is already well defined.…”