Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model
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- dc.contributor.author Castells, Xavier
- dc.contributor.author Comas Serrano, Mercè
- dc.contributor.author Arrospide, Arantzazu
- dc.contributor.author Mar, Javier
- dc.contributor.author Sala, Maria
- dc.contributor.author Vilaprinyó, Ester
- dc.contributor.author Hernández, Cristina
- dc.contributor.author Cots, Francesc
- dc.contributor.author Martínez, Juan
- dc.contributor.author Castells, Xavier
- dc.date.accessioned 2025-01-10T07:19:02Z
- dc.date.available 2025-01-10T07:19:02Z
- dc.date.issued 2014
- dc.description.abstract Objective: To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. Methods: A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Results: Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Conclusions: Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.
- dc.format.mimetype application/pdf
- dc.identifier.citation Comas M, Arrospide A, Mar J, Sala M, Vilaprinyó E, Hernández C, et al. Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model. PLoS One. 2014 May 15;9(5):e97459. DOI: 10.1371/journal.pone.0097459
- dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0097459
- dc.identifier.issn 1932-6203
- dc.identifier.uri http://hdl.handle.net/10230/69040
- dc.language.iso eng
- dc.publisher Public Library of Science (PLoS)
- dc.relation.ispartof PLoS One. 2014 May 15;9(5):e97459
- dc.rights © 2014 Comas et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Mammography
- dc.subject.keyword Breast cancer
- dc.subject.keyword Cancer screening
- dc.subject.keyword Cancer treatment
- dc.subject.keyword Cancer detection and diagnosis
- dc.subject.keyword Death rates
- dc.subject.keyword Biopsy
- dc.subject.keyword Simulation and modeling
- dc.title Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion