A Longer Breast Carcinoma Screening Interval for Women Age Older Than 65 Years?

Published in: Cancer, v. 86, no. 8, Oct. 15, 1999, p. 1506-1510

Posted on RAND.org on December 31, 1998

by Rob Boer, Harry J. de Koning, Paul J. van der Maas

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BACKGROUND: The observed increase in sojourn time for preclinical breast carcinoma raises the question of whether women age >/= 65 years can be screened less frequently than younger women. METHODS: A cost-utility analysis using a computer model that simulates the demography, epidemiology, and natural history of breast carcinoma to estimate expected life-years gained, extra incidence, extra life-years with disease, and costs incurred by different breast carcinoma screening programs in the general population was conducted. RESULTS: The estimated ratio of favorable/unfavorable effects was lower for longer screening intervals compared with shorter screening intervals. The cost-effectiveness ratio was much less favorable in shorter screening intervals. CONCLUSIONS: The results of the current analysis showed that although a longer sojourn time for preclinical breast carcinoma should not necessarily be accompanied by a longer screening interval, a shorter screening interval was not very efficient.

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