Analysis of Health Benefits and Cost-Effectiveness of Mammography for Breast Cancer
Authors: John T. Schousboe, Karla Kerlikowske, Steven R. Cummings
Journal: Annals of Internal Medicine (2011)

Letters18 October 2011Analysis of Health Benefits and Cost-Effectiveness of Mammography for Breast CancerJohn T. Schousboe, MD, PhD, Karla Kerlikowske, MD, MS, and Steven R. Cummings, MDJohn T. Schousboe, MD, PhDFrom Park Nicollet Institute, Minneapolis, MN 55426; Veterans Affairs Medical Center, San Francisco, CA 94121; and California Pacific Medical Center Research Institute Coordinating Center, San Francisco, CA 94107.Search for more papers by this author, Karla Kerlikowske, MD, MSFrom Park Nicollet Institute, Minneapolis, MN 55426; Veterans Affairs Medical Center, San Francisco, CA 94121; and California Pacific Medical Center Research Institute Coordinating Center, San Francisco, CA 94107.Search for more papers by this author, and Steven R. Cummings, MDFrom Park Nicollet Institute, Minneapolis, MN 55426; Veterans Affairs Medical Center, San Francisco, CA 94121; and California Pacific Medical Center Research Institute Coordinating Center, San Francisco, CA 94107.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-8-201110180-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Keen for his thoughtful comments regarding our cost-effectiveness modeling study of mammography. We agree that the costs relative to health benefits gained of performing annual compared with biennial screening mammography are very high, and our analyses may have underestimated these costs. From the societal perspective, additional costs of mammography could be included, among them time and travel costs to and from a breast imaging facility. However, advanced breast cancer may result in more disability, and one must also account for the cost of replacing disabled women in the workplace (1). If more frequent mammography detects ...References1. Koopmanschap MA, van Ineveld BM. Towards a new approach for estimating indirect costs of disease. Soc Sci Med. 1992;34:1005-10. [PMID: 1631600] CrossrefMedlineGoogle Scholar2. Biesheuvel C, Barratt A, Howard K, Houssami N, Irwig L. Effects of study methods and biases on estimates of invasive breast cancer overdetection with mammography screening: a systematic review. Lancet Oncol. 2007;8:1129-38. [PMID: 18054882] CrossrefMedlineGoogle Scholar3. de Gelder R, Heijnsdijk EA, van Ravesteyn NT, Fracheboud J, Draisma G, de Koning HJ. Interpreting overdiagnosis estimates in population-based mammography screening. Epidemiol Rev. 2011;33:111-21. [PMID: 21709144] CrossrefMedlineGoogle Scholar4. 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 Scholar Author, Article, and Disclosure InformationAffiliations: From Park Nicollet Institute, Minneapolis, MN 55426; Veterans Affairs Medical Center, San Francisco, CA 94121; and California Pacific Medical Center Research Institute Coordinating Center, San Francisco, CA 94107.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-2871. 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 D. Keen Metrics Cited ByPersonalized Care: A Clinical Decision Support System for Breast Cancer Screening Using Clustering and Classification 18 October 2011Volume 155, Issue 8Page: 566-567KeywordsAnxietyBreast cancerDigital imagingDisclosureLesionsMammographyMedicareQuality of lifeResearch design ePublished: 18 October 2011 Issue Published: 18 October 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...