The costs and effects of cervical and breast cancer screening in a public hospital emergency room Journal Article

Authors: Mandelblatt, J.; Freeman, H.; Winczewski, D.; Cagney, K.; Williams, S.; Trowern, R.; Tang, J.; Gold, K.; Lin Hsiang, T.; Kerner, J.
Article Title: The costs and effects of cervical and breast cancer screening in a public hospital emergency room
Abstract: Objectives: This study assessed the cost-effectiveness of cervix and breast cancer screening in a public hospital emergency room. Methods: Age- eligible women with nonurgent conditions and without recent screening were offered screening by a nurse. A decision analysis compared the costs and outcomes of emergency room screening and standard hospital screening efforts. Results: The undiscounted cost-effectiveness results for establishing new programs were $4050 (cervical cancer), $403 203 (breast cancer), and $4375 (joint cervix and breast cancer) per year of life saved. If screening is added to an existing program, results are more favorable ($429, $21 324, and $479 per year of life saved for cervix, breast, and joint screening, respectively). Results were most sensitive to volume and probability of receiving treatment after an abnormal screen. Conclusions: Emergency room screening was cost-effective for cervical cancer; breast cancer screening was relatively expensive given the low number of women reached. More intensive recruitment and follow-up strategies are needed to maximize the cost- effectiveness of such programs.
Keywords: adult; controlled study; aged; survival analysis; major clinical study; united states; breast cancer; incidence; cancer screening; mass screening; breast neoplasms; cost effectiveness analysis; emergency ward; emergency service, hospital; mammography; probability; uterine cervix cancer; breast examination; seer program; uterine cervical neoplasms; life expectancy; cost-benefit analysis; decision trees; public hospital; hospitals, public; urban population; vaginal smears; papanicolaou test; health services accessibility; humans; human; female; article; medical indigency
Journal Title: American Journal of Public Health
Volume: 87
Issue: 7
ISSN: 0090-0036
Publisher: American Public Health Association  
Date Published: 1997-07-01
Start Page: 1182
End Page: 1189
Language: English
PUBMED: 9240110
PROVIDER: scopus
PMCID: PMC1380894
Notes: Article -- Export Date: 17 March 2017 -- Source: Scopus
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