Economic evaluation on breast cancer screening in mainland China: a systematic review
10.3760/cma.j.issn.0254-6450.2016.12.021
- VernacularTitle:我国乳腺癌筛查卫生经济学研究的系统评价
- Author:
Le WANG
1
;
Jufang SHI
;
Huiyao HUANG
;
Juan ZHU
;
Jiang LI
;
Yi FANG
;
Min DAI
Author Information
1. 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院城市癌症早诊早治项目办公室
- Keywords:
Breast neoplasms;
Mass screening;
Economic evaluation;
Systematic review
- From:
Chinese Journal of Epidemiology
2016;37(12):1662-1669
- CountryChina
- Language:Chinese
-
Abstract:
Objective To gather available evidence related to the economic evaluation on breast cancer screening in mainland China and to provide reference for further research.Methods A systematic review was conducted to identify articles in PubMed and three Chinese databases (CNKI,Wanfang and VIP) during 1995-2015.Data related to descriptive characteristics,rates on participation and detection for population-based studies,methods for model-based studies,types of economic evaluation and results,were extracted.A Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the reporting quality of included studies.Results Of the 356 records searched in the databases,13 studies (all published between 2012 and 2015) were included in the current paper involving 11 population-based studies and 3 model-based evaluations (1 study using both methods).Age of the participants who started to be engaged in the screening program ranged from 18 to 45 years old,but terminated at the age of 59 years or older.The screening modalities included single-used clinical breast examination,mammography and ultrasound or combined applications.Study persepectives were described in 7 studies,with 5 from the healthcare providers,and 2 from societal angles.Only 5 studies discounted cost or effectiveness.Out of 11 papers,9 showed the results on cost-effectiveness analysis (CEA) that reporting the cost per breast cancer detection,with median as 145.0 thousand Chinese Yuan (CNY),ranging from 49.7 thousand to 2 293.0 thousand CNY.From 4 papers with results of cost-utility analysis (CUA),the cost per quality adjusted life year (QALY) gained or cost per disability adjusted life year (DALY) averted,were evaluated.The incremental cost-effectiveness ratio (ICER) was from 2.9 thousand to 270.7 thousand CNY (GDP per capita of China was CNY 49.3 thousand in 2015).In 13 studies,the quality of reporting varied,with an average score of 14.5 (range:9.5-21.0).In the domains of study perspective,discounting,ICER and uncertainty,all the scores of equalities were relatively levels.Conclusions Currently,evidence on economic evaluation of breast cancer screening in mainland China remained limited and weakly comparable,particularly model-based studies.Comprehensive analysis from societal perspective and QALY or DALY related cost-utility analysis should be implemented.
