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Article first published online: 5 JUN 2008
Copyright © 2008 American Cancer Society
Volume 113, Issue 3, pages 592–601, 1 August 2008
How to Cite
Ekwueme, D. U., Hall, I. J., Richardson, L. C., Gardner, J. G., Royalty, J. and Thompson, T. D. (2008), Estimating personal costs incurred by a woman participating in mammography screening in the National Breast and Cervical Cancer Early Detection Program. Cancer, 113: 592–601. doi: 10.1002/cncr.23613
The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
This article is a U.S. Government work and, as such, is in the public domain in the United States of America.
- Issue published online: 18 JUL 2008
- Article first published online: 5 JUN 2008
- Manuscript Accepted: 20 MAR 2008
- Manuscript Revised: 14 MAR 2008
- Manuscript Received: 14 JAN 2008
- personal cost;
- indirect cost;
- opportunity cost;
- transaction cost;
- mammography screening;
- National Breast and Cervical Cancer Early Detection Program
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) covers the direct clinical costs of breast and cervical cancer screening and diagnostic follow-up for medically underserved, low-income women. Personal costs are not covered. In this report, the authors estimated personal costs per woman participating in NBCCEDP mammography screening by race/ethnicity and also estimated lifetime personal costs (ages 50-74 years).
A decision analysis model was constructed and parameterized by using empiric data from a retrospective cohort survey of mammography rescreening among women ages 50 years to 64 years who participated in the NBCCEDP. Data from 1870 women were collected from 1999 to 2000. The model simulated the flow of resources incurred by a woman participating in the NBCCEDP. The analysis was stratified by annual income into 2 scenarios: Scenario 1, <$10,000; and Scenario 2, from $10,000 to <$20,000. Sensitivity analyses were conducted to appraise uncertainty, and all costs were standardized to 2000 U.S. dollars.
In Scenario 1, for all races/ethnicities, a woman incurred a 1-time cost of $17 and a discounted lifetime cost of $108 for 10 screens and $262 for 25 screens; in Scenario 2, these amounts were $31 and from $197 to $475, respectively. In both scenarios, a non-Hispanic white woman incurred the highest cost. The sensitivity analyses revealed that >70% of cost incurred was attributable to opportunity cost.
Capturing and quantifying personal costs will help ascertain the total cost (ie, societal cost) of providing mammography screening to a medically underserved, low-income woman participating in a publicly funded cancer screening program and, thus, will help determine the true cost-effectiveness of such programs. Cancer 2008. Published 2008 by the American Cancer Society.