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The cost-effectiveness of risk-stratified breast cancer screening in the UK

Hill, Harry; Kearns, Ben; Pashayan, Nora; Roadevin, Cristina; Sasieni, Peter; Offman, Judith; Duffy, Stephen

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Authors

Harry Hill

Ben Kearns

Nora Pashayan

Peter Sasieni

Judith Offman

Stephen Duffy



Abstract

There has been growing interest in the UK and internationally of risk-stratified breast screening whereby individualised risk assessment may inform screening frequency, starting age, screening instrument used, or even decisions not to screen. This study evaluates the cost-effectiveness of eight proposals for risk-stratified screening regimens compared to both the current UK screening programme and no national screening. A person-level microsimulation model was developed to estimate health-related quality of life, cancer survival and NHS costs over the lifetime of the female population eligible for screening in the UK. Compared with both the current screening programme and no screening, risk-stratified regimens generated additional costs and QALYs, and had a larger net health benefit. The likelihood of the current screening programme being the optimal scenario was less than 1%. No screening amongst the lowest risk group, and triannual, biennial and annual screening amongst the three higher risk groups was the optimal screening strategy from those evaluated. We found that risk-stratified breast cancer screening has the potential to be beneficial for women at the population level, but the net health benefit will depend on the particular risk-based strategy. [Abstract copyright: © 2023. The Author(s).]

Citation

Hill, H., Kearns, B., Pashayan, N., Roadevin, C., Sasieni, P., Offman, J., & Duffy, S. (2023). The cost-effectiveness of risk-stratified breast cancer screening in the UK. British Journal of Cancer, 129(11), 1801-1809. https://doi.org/10.1038/s41416-023-02461-1

Journal Article Type Article
Acceptance Date Oct 4, 2023
Online Publication Date Oct 17, 2023
Publication Date Nov 23, 2023
Deposit Date Feb 13, 2025
Publicly Available Date Mar 6, 2025
Print ISSN 0007-0920
Electronic ISSN 1532-1827
Publisher Cancer Research UK
Peer Reviewed Peer Reviewed
Volume 129
Issue 11
Pages 1801-1809
DOI https://doi.org/10.1038/s41416-023-02461-1
Public URL https://nottingham-repository.worktribe.com/output/27069975
Publisher URL https://www.nature.com/articles/s41416-023-02461-1

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