Evaluación de la utilidad de un programa de cribado mamográfico en Bogotá, Colombia / Evaluating the usefulness of a breast screening program in Bogotá, Colombia
Rev. salud pública
;
14(1): 41-52, 2012. ilus, tab
Artigo
em Espanhol
| LILACS
| ID: lil-659899
RESUMEN
Objetivo Evaluar mediante un modelo de simulación la utilidad de un programa organizado de cribado mamográfico en Bogotá, Colombia. Material y Métodos Diseño análisis de costo-efectividad usando el modelo Markov. Se compara la realización de cribado mamográfico bienal en mujeres de 50 a 69 años con respecto al statu quo en el cual no existe este programa. Se evalúa sobrevida, costos e incrementos en la tasa de costo-efectividad. Resultados El modelo muestra una reducción de la tasa de mortalidad por cáncer de mama en el esquema de cribado mamográfico de ciclo bienal. Se observa que hay un incremento lineal de los años de vida acumulados desde el tercer ciclo con un ahorro acumulado de costos de tratamiento en las diferentes tasas de cribado generando ahorros al sistema de salud.La Razón de costo por año de vida ganado y Producto interno bruto se hace menor de 3 por encima del 50 % de cobertura (indicando que es una intervención costo-efectiva). El costo medio del programa experimenta una disminución porcentual del 40 % cuando se llega al ciclo 10. De allí la disminución de este costo es menor. Conclusiones Según el modelo desarrollado es costo-efectivo adelantar un programa de cribado mamográfico bienal con cobertura mayor al 50 %, obteniéndose reducción en la mortalidad que se hace más notoria desde el tercer ciclo del esquema evaluado, obteniendo un ahorro en los recursos queelsistema de salud destina al cáncer de mama.
ABSTRACT
Objective Using a simulation model for evaluating the usefulness of an organized breast cancer screening program in Bogotá, Colombia Material and methods The Markov model was used for designing a cost-effectiveness analysis; this was compared to a biennial breast cancer screening for women aged 50 to 69 years old. The disease's natural history, breast screening studies and publications concerning breast cancer were used as input for the model; the number of diagnosed cancer cases, stage distribution and mortality, survival, costs and increased effectiveness rate were also analyzed. Results The model showed that breast cancer mortality rate decreased in biennial breast cancer screening. Life-years-gained became increased from the third cycle onwards. The ratio between the cost of a life-year-gained and gross domestic product was lower than 3 when more than 50 % of the population were screened (meaning that such program would be cost-effective). The program's lowest average cost was achieved by increasing the number of screening cycles as far as the sixth cycle. Conclusions The simulation model for studying the impact of changing a breast cancer screening program's coverage for women aged 50 to 69 years led to ascertaining that introducing biennial frequency would be cost-effective when more than 50 % of the population were studied. A lower mortality rate would result, mainly from the third cycle onwards, thereby saving important health system resources in Bogotá, Colombia.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Neoplasias da Mama
/
Mamografia
/
Detecção Precoce de Câncer
Tipo de estudo:
Estudo diagnóstico
/
Estudos de avaliação
/
Avaliação Econômica em Saúde
/
Estudo prognóstico
/
Fatores de risco
/
Estudo de rastreamento
Limite:
Idoso
/
Feminino
/
Humanos
País/Região como assunto:
América do Sul
/
Colômbia
Idioma:
Espanhol
Revista:
Rev. salud pública
Assunto da revista:
Saúde Pública
Ano de publicação:
2012
Tipo de documento:
Artigo
País de afiliação:
Colômbia
Instituição/País de afiliação:
Universidad Nacional de Colombia/CO
Similares
MEDLINE
...
LILACS
LIS