COST-EFFECTIVENESS OF CANCER SCREENING IN THE ELDERLY. J.S. Rich 1 , J.D. Birkmeyer 1 ; VA Medical Center, White River Junction, VT PURPOSE: Although the benefits of continuing to screen for cancer in the elderly are unknown, the elderly are screened. We developed a Markov model to estimate the costeffectiveness of continuing to screen for cancer beyond 70 years of age. METHODS: For each of three cancers (breast, cervical and colon), we estimated the marginal cost-effectiveness of continuing to screen average risk elderly men and women who had previously undergone regular screening. All-cause and cancer-specific mortality data were obtained from the National Center for Health Statistics and the Surveillance Epidemiology and End Results survey. Assuming that the benefits of screening seen in younger patients extend to the elderly, we used a reduction in cancer-specific mortality of 27% for biennial mammography and 33% for annual fecal occult blood testing (FOBT) to model screening benefits. We assumed a 70% reduction in cervical cancer mortality to model benefits with triennial screening Pap smears. Three costs were included: cost of the screening test, cost to evaluate an abnormal, and the cost of cancer care. We assumed that there were no harms with screening. RESULTS: The table below shows the incremental gains in life expectancy and costeffectiveness of continuing to screen the elderly for cancer. The values for the 70 ± 79 year old interval are compared to stopping screening at age 69; the values for the 80 years and over interval are compared to stopping screening at age 79.