© 2004 by European Journal of Public Health
Chronic diseases |
Lower costs of hospital treatment of breast cancer through a population-based mammography screening programme
Lea Kauhava1, Pirjo Immonen-Räihä2, Ilmo Parvinen3, Hans Helenius4, Anne Kaljonen5, Osmo Räsänen6, Liisa Pylkkänen7 and Pekka J. Klemi81 Financial Department, Health Office City of Turku 2 Raisio Regional Hospital 3 Finnish National Fund for Research and Development 4 Department of Biostatistics, University of Turku 5 Biostatistical consultant 6 Cancer Society of Southwest Finland 7 Department of Radiotherapy and Oncology, University Hospital of Turku 8 Department of Pathology, University Hospital of Turku, Finland
Background: The objective of this study was to evaluate the hospital treatment costs of invasive breast cancer in relation to the mode of detection, i.e. by mammography screening, between screenings or without screening during a population-based mammography screening programme, which started in 1987 among 36,000 women aged 40 to 74 years in the city of Turku, Southwest Finland. Methods: The treatment costs and survival days of 556 women diagnosed with invasive breast cancer at the age of 40 to 74 years in 1987 to 1993 were followed up for five years from diagnosis or until death, whichever occurred first. Results: Screen-detected cancers had the lowest average costs. The mean treatment costs per patient were 1.4-fold for clinical cancers and 1.3-fold for interval cancers compared to screen-detected cancers (p<0.001). The corresponding ratios in the mean treatment costs per survival day were 3.5 for clinical cancers and 1.9 for interval cancers (p<0.001). The mean treatment costs per patient were 1.3-fold for the non-screened group (clinical cancers) compared to the screened group (screen-detected and interval cancers) (p<0.001). The corresponding ratio was 3, when the mean treatment costs per survival day were compared (p<0.001). The estimated savings resulting from early treatment were 26–30% measured as a proportion of the screening costs for 1987 to 1993. Conclusion: The treatment costs of screen-detected cancers are lower than those of cancers detected by other methods. The study shows the potential for reducing treatment costs through early detection of breast cancer by mammography screening.
Keywords: breast cancer, cost savings, mammography screening, treatment costs
Received 18 July 2002. Accepted 3 February 2003.
* Correspondence: Lea Kauhava, M.Sc., Financial Department, Health Office City of Turku, POB 1, FIN-20701 Turku, Finland, tel. +358 2 2692937, fax +358 2 2692553, e-mail: lea.kauhava{at}turku.fi