RESUMEN
Objective: This study aims to analyze the cost-effectiveness and cost-utility of ultrasonography screening, mammography screening and no screening for breast cancer among Chinese women.Methods: A Markov model was developed from a societal perspective among asymptomatic Chinese women over 40 years who are at risk for breast cancer over a lifetime horizon.The decision model was populated with data derived from China, discounted at 3%.After getting the incremental cost-utility ratio (ICUR), this paper explores the parameter uncertainty using one-way sensitivity analysis and probabilistic sensitivity analysis.Subgrouping analysis was conducted based on different city levels and geographical areas in China.Results: Compared to no screening, the incremental cost-utility ratio of ultrasonography screening is ￥102653/QALY and the ICUR of mammography screening is ￥201309/QALY.In probabilistic sensitivity analyses, the probabilities of the ICUR being a threshold of ￥140000/QALY are 54.5% for annual ultrasonography and 26.2% for annual mammography.The subgrouping analysis shows that compared with no screening the ultrasonography screening for breast cancer has high cost-utility in all levels of cities and all geographic areas in China.The ICUR of mammography screening compared with no screening is very close to the threshold in eastern China.Conclusions: Ultrasonography screening could be used as the primary method for breast cancer screening in China, while mammography screening could only be used in economically developed areas in eastern China.