Analysis of Health Benefits and Cost-Effectiveness of Mammography for Breast Cancer
Authors: John D. Keen
Journal: Annals of Internal Medicine (2011)

Letters18 October 2011Analysis of Health Benefits and Cost-Effectiveness of Mammography for Breast CancerJohn D. Keen, MD, MBAJohn D. Keen, MD, MBAFrom Stroger Hospital of Cook County, Chicago, IL 60612.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-8-201110180-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Schousboe and colleagues (1) have contributed to the mammographic screening debate by calculating the cost-effectiveness ratio of annual screening compared with biennial screening for all ages as more than $340 000 per quality-adjusted life-year (QALY), from a “national payer” perspective. The American Cancer Society and some professional groups who benefit from screening advocate this aggressive annual schedule.Unfortunately, this cost-effectiveness ratio understates the case by ignoring indirect costs in the societal perspective, including substantial time and travel costs (2). Screening mammograms and recall examinations cause anxiety, and this harm should have been included in the base-case analysis and ...References1. Schousboe JT, Kerlikowske K, Loh A, Cummings SR. Personalizing mammography by breast density and other risk factors for breast cancer: analysis of health benefits and cost-effectiveness. Ann Intern Med. 2011;155:10-20. [PMID: 21727289] LinkGoogle Scholar2. Tosteson AN, Stout NK, Fryback DG, Acharyya S, Herman BA, Hannah LG, et al; DMIST Investigators. Cost-effectiveness of digital mammography breast cancer screening. Ann Intern Med. 2008;148:1-10. [PMID: 18166758] LinkGoogle Scholar3. Jørgensen KJ, Keen JD, Gøtzsche PC. Is mammographic screening justifiable considering its substantial overdiagnosis rate and minor effect on mortality? Radiology. 2011;260:621-7. [PMID: 21846758] CrossrefMedlineGoogle Scholar4. U.S. Food and Drug Administration. Mammography Quality and Standards Act National Statistics. Silver Spring, MD: U.S. Food and Drug Administration; 2011. Accessed at www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm on 6 July 2011. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Stroger Hospital of Cook County, Chicago, IL 60612.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Digital Mammography Breast Cancer Screening Anna N.A. Tosteson , Natasha K. Stout , Dennis G. Fryback , Suddhasatta Acharyya , Benjamin A. Herman , Lucy G. Hannah , Etta D. Pisano , and Personalizing Mammography by Breast Density and Other Risk Factors for Breast Cancer: Analysis of Health Benefits and Cost-Effectiveness John T. Schousboe , Karla Kerlikowske , Andrew Loh , and Steven R. Cummings Analysis of Health Benefits and Cost-Effectiveness of Mammography for Breast Cancer John T. Schousboe , Karla Kerlikowske , and Steven R. Cummings Metrics Cited ByConfidentCare: A Clinical Decision Support System for Personalized Breast Cancer ScreeningAggregate Cost of Mammography Screening in the United StatesJohn D. Keen, MD, MBARecent data show that mammographic screening of asymptomatic women is effective and essential 18 October 2011Volume 155, Issue 8Page: 566KeywordsBreast cancerDatabasesDecision makingForecastingMammographyMedicareSurgery ePublished: 18 October 2011 Issue Published: 18 October 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...