RESUMO
This article is designed to assist healthcare professionals in identifying begin and end ages for annual breast cancer mammography screening through the use of cost-effectiveness and computer modeling. With a limit of acceptability of $50,000 per life-year saved, the ages of screening were found to be 35 to 85. The present study identifies the end age for screening more clearly than currently available evidence while meeting the societal limits of $50,000 per life-year saved and equitable spending for the young and old alike.
Assuntos
Simulação por Computador , Mamografia/economia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico por imagem , Análise Custo-Benefício , Feminino , Humanos , Pessoa de Meia-Idade , Estados UnidosRESUMO
A computer model based on relational database techniques was used to analyze the relationship between staging and population compliance to a breast cancer screening protocol. Stage distribution data permitted estimates of compliance to the protocol. This relationship followed the equation y=5.83e-2.44x where y was compliance and x was disease stage. Application of this equation to SEER and NCDB data estimated that the levels of compliance never exceeded 16 percent. Results indicated increasing clinical Stage IV disease as population compliance decreased. As the clinical staging increased there was increased sub-clinical Stage IV disease. With regular screening, simulation suggested that mortality would decrease.
Assuntos
Neoplasias da Mama/patologia , Simulação por Computador , Modelos Teóricos , Estadiamento de Neoplasias/métodos , Cooperação do Paciente , Adulto , Protocolos Clínicos , Feminino , Humanos , Mamografia , Programas de Rastreamento/normas , Pessoa de Meia-IdadeRESUMO
Healthcare professionals must make breast cancer screening decisions without the help of clear answers in current medical knowledge. This study used computer simulation to evaluate two screening protocols. The American Cancer Society (ACS) protocol comprising self-breast examination, professional breast examination and annual mammography was evaluated versus annual mammography alone. The effective frequency of mammography and the cost in the ACS protocol doubles the cost of mammography alone. Breast self-examination and clinical breast examination contributes to increased cost without any added health effects. These study results could be applied by healthcare professionals to assist their decision making for breast cancer screening.
