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 |
DOI/URL: | |
Notes: | Article -- Export Date: 17 March 2017 -- Source: Scopus |