Abstract
Objectives:To conduct cost effectiveness and benefit-cost analyses of the organized mammography-screening program in the Republic of Kazakhstan comparing women who developed breast cancer in screened and unscreened scenario. Methods:389,352 screened women were included in the study. Among these, 895 women were further diagnosed with breast cancer. Outcomes measures include life years saved, quality-adjusted life years, incremental cost-effectiveness ratio, and value of statistical life year. Sensitivity analyses were performed to assess uncertainty.Results:Compared to no screening scenario, an organized mammography yielded an additional 1,253 life years and 790 quality-adjusted life years in 2016. The incremental cost-effectiveness ratio was equal to 3,157 USD per one QALY saved, which is two times less than the GDP per capita in Kazakhstan in 2016. Sensitivity analysis showed that the mammography remains cost-effective in the majority of the scenarios. Conclusion:Mammography screening in Kazakhstan was found to be highly cost-effective, associated with treatment cost savings, and can be an efficient use of limited resources in Kazakhstan.
Highlights
Breast cancer is the most commonly diagnosed type of cancer in a resource-limited post-Soviet country of Kazakhstan (Baizhumanova and Sakamoto, 2010; Toleutay et al, 2013)
Women with breast cancer who had mammography screening was associated with 15% reduction in breast cancer mortality rates
Our study found that in 2016 the mammography-screening program in Kazakhstan was cost-effective with the incremental costeffectiveness ratio equaled to USD 3,157
Summary
Breast cancer is the most commonly diagnosed type of cancer in a resource-limited post-Soviet country of Kazakhstan (Baizhumanova and Sakamoto, 2010; Toleutay et al, 2013). In some regions of Kazakhstan, incidence rates of breast cancer have reached 274 per 100,000 (Bilyalova et al, 2012). In 2014, breast cancer accounted for 17% of all deaths from cancer in Kazakhstan (http://www.who.int/cancer/country-profiles/kaz_en.pdf). In Kazakhstan, national mammography screening program was introduced in 2008. It is a biennial program, which targets women aged 50, 52, 54, 56, 58, and 60 (Beysebayev E. et al, 2015). During 2016, the mammography-screening program covered 389,352 women and identified 895 new cases of breast cancer, which amounted to 0.2% of the total number of screened women
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