E-ISSN 2587-0831
Original Article
Cost-Effectiveness of Breast Cancer Screening in Turkey, a Developing Country: Results from Bahçeşehir Mammography Screening Project
1 Department of Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey  
2 Departments of Surgery, Namık Kemal University School of Medicine, Tekirdağ, Turkey  
3 Department of Public Health, Marmara University School of Medicine, İstanbul, Turkey  
4 Departments of Radiology, University Health Sciences, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey  
5 Department of Radiology, Marmara University School of Medicine, İstanbul, Turkey  
6 Department of Radiology, University Health Sciences, İstanbul Şisli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey  
7 Department of Medical Oncology, İstanbul University School of Medicine, İstanbul, Turkey  
8 Department of Industrial & Systems Engineering and Population Health Sciences, UW Carbone Cancer Center, University of Wisconsin Hospital and Clinics, Madison, WI, USA  
Eur J Breast Health 2017; 13: 117-122
DOI: 10.5152/ejbh.2017.3528
This article was viewed 162 times, downloaded 100 times

Key Words: Mammography screening, breast cancer screening Turkey, cost-effectiveness of breast cancer screening
Abstract

Objective: We used the results from the first three screening rounds of Bahcesehir Mammography Screening Project (BMSP), a 10-year (2009-2019) and the first organized population-based screening program implemented in a county of Istanbul, Turkey, to assess the potential cost-effectiveness of a population-based mammography screening program in Turkey. 

 

Materials and Methods: Two screening strategies were compared: BMSP (includes three biennial screens for women between 40-69) and Turkish National Breast Cancer Registry Program (TNBCRP) which includes no organized population-based screening. Costs were estimated using direct data from the BMSP project and the reimbursement rates of Turkish Social Security Administration. The life-years saved by BMSP were estimated using the stage distribution observed with BMSP and TNBCRP. 

 

Results: A total of 67 women (out of 7234 screened women) were diagnosed with breast cancer in BMSP. The stage distribution for AJCC stages O, I, II, III, IV was 19.4%, 50.8%, 20.9%, 7.5%, 1.5% and 4.9%, 26.6%, 44.9%, 20.8%, 2.8% with BMSP and TNBCRP, respectively. The BMSP program is expected to save 279.46 life years over TNBCRP with an additional cost of $677.171, which implies an incremental cost-effectiveness ratio (ICER) of $2.423 per saved life year. Since the ICER is smaller than the Gross Demostic Product (GDP) per capita in Turkey ($10.515 in 2014), BMSP program is highly cost-effective and remains cost-effective in the sensitivity analysis.

 

Conclusion: Mammography screening may change the stage distribution of breast cancer in Turkey. Furthermore, an organized population-based screening program may be cost-effective in Turkey and in other developing countries. More research is needed to better estimate life-years saved with screening and further validate the findings of our study.

 

Cite this article as: Özmen V, Gürdal SÖ, Cabioğlu N, Özçınar B, Özaydın AN, Kayhan A, Arıbal E, Şahin C, Saip P, Alagöz O. Cost-Effectiveness of Breast Cancer Screening in Turkey, a Developing Country: Results from Bahçeşehir Mammography Screening Project. Eur J Breast Health 2017; 13: 117-122.

Key Words
Authors
All
Congresses
Author’s Corner
Survey
AVES | Copyright © 2017 Turkish Federation of Breast Diseases Associations | Latest Update: 27.09.2017