Cost-Effectiveness of Digital Mammography Breast Cancer Screening
- Anna N.A. Tosteson, ScD;
- Natasha K. Stout, PhD;
- Dennis G. Fryback, PhD;
- Suddhasatta Acharyya, PhD;
- Benjamin A. Herman, SM;
- Lucy G. Hannah, MS, MAT;
- Etta D. Pisano, MD; and
- for the DMIST Investigators*
- From The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, New Hampshire; Harvard School of Public Health, Boston, Massachusetts; University of Wisconsin, Madison, Wisconsin; Brown University, Providence, Rhode Island; and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Figure 1. Flow diagram of screening strategies evaluated.Each year, women enter a film or digital simulation on the basis of breast density and current age.
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Figure 2. Effect of digital mammography cost on the incremental cost-effectiveness ratio (ICER).The cost of digital mammography may be interpreted as a premium compared with film mammography, in which $98 represents a $12 premium and $135 represents a $50 premium over film mammography. The ICER for age- and density-targeted screening is computed relative to age-targeted screening. The ICERs for all other strategies are computed relative to film mammography screening. QALY = quality-adjusted life-year.
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