br Conclusions br Breast cancer
Breast cancer inflicts substantial health and financial burden to women in the United States and worldwide. Screening mammography can reduce the disease burden of breast cancer through early detection and timely intervention. Nevertheless, policy makers designing breast cancer screening programs for the VH-298 must also consider harms associated with screening mammography, such as false-positive screening results, over-diagnosis and overtreatment. This study applied a micro-simulation model to assess the cost-effectiveness of breast cancer screening guidelines updated by professional societies (e.g., USPSTF and ACS) in the US in late 2015/early 2016. Findings from our model suggested that the most cost-effective screening strategy for women at an average risk of developing breast cancer
was a hybrid strategy that starts annual mammography screening at the age of age 45 years and switches to biennial screening be-tween the age of 55 years and 75 years e a strategy that conformed to the updated ACS guideline. Future research should extend the model to explore whether the cost-effectiveness of screening strategies would be altered by the rates of screening adherence, especially among selected population subgroups, as well as among women at higher risk of developing breast cancer.
We thank Ms LeeAnn Chastain from the Department of Biosta-tistics at The University of Texas MD Anderson Cancer Center for reviewing and editing the manuscript. We also acknowledge the efforts of the Applied Research Program, National Cancer Insti-tute; the Office of Research, Development and Information, Cen-ters for Medicare & Medicaid Services; Information Management Services, Inc.; and the SEER Program tumor registries in the cre-ation of the SEER-Medicare database.
This study used the linked SEER-Medicare database. Y.-C. T. Shih is a member of the American Cancer Society Cancer Screening Guideline Development Group and had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Source of financial support: This work was supported in part by grants from the National Cancer Institute (grant no. R21CA165092 to Y.-C. T. Shih and Y. Shen; grant no. R01CA079466 to Y. Shen), the Agency for Healthcare Research and Quality (grant no. R01HS020263 to Y.-C. T. Shih), and the Duncan Family Institute. The interpretation and reporting of study findings are the sole responsibility of the authors.
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