Abstract
Background: In 2018, the global estimate of newly diagnosed breast cancer cases among women totaled 2.1 million. The economic and social burden that breast cancer places on societies has propelled research that analyzes the role of modifiable risk factors as the primary prevention methods. Healthy behavior changes, moderated alcohol intake, healthy body weight, and regular physical activity may decrease the risk of breast cancer among women. This review aimed to synthesize evidence on the cost-effectiveness of lifestyle-related interventions for the primary prevention of breast cancer in order to answer the question on whether implementing interventions focused on behavior changes are worth the value for money.Methods: A rapid review was performed using search terms developed by the research team. The articles were retrieved from MEDLINE and the Tufts Medical Center Cost-Effectiveness Analysis Registry, with an additional web search in Google and Google Scholar. Comparisons were performed on the cost-effectiveness ratio per quality-adjusted life-year between the interventions using a league table, and the likelihood of cost-effective interventions for breast cancer primary prevention was analyzed.Results: Six studies were selected. The median cost-effectiveness ratio (in 2018 USD) was $24,973, and 80% of the interventions had a ratio below the $50,000 threshold. The low-fat-diet program for postmenopausal women was cost-effective at a societal level, and the physical activity interventions, such as the Be Active Program in the UK, had the best cost saving results. A total of 11 of the 25 interventions ranked either as highly or very highly likely to be cost-effective for breast cancer primary preventions.Conclusion: Although the review had some limitations due to using only a few studies, it showed evidence that diet-related and physical-activity-related interventions for the primary prevention of breast cancer were cost-effective. Many of the cost-effective interventions aimed to reduce the risk of non-communicable diseases alongside breast cancer.
Highlights
Breast cancer has been ranked as the leading cause of cancer deaths in over 100 countries, accounting for 11.6% of all cancer deaths worldwide [1, 2]
We found one protocol which analyzes the impact and the costeffectiveness of the lifestyle interventions for breast cancer, but the results of this study will not be published until the end of 2019 [35]
The rapid review of the six primary prevention studies highlighted that the use of physical activity (PA) programs and low-fat-diet interventions among particular subgroups of women had high cost-effectiveness
Summary
Breast cancer has been ranked as the leading cause of cancer deaths in over 100 countries, accounting for 11.6% of all cancer deaths worldwide [1, 2]. Breast cancer has been associated with increased healthcare costs and productivity losses [1,2,3,4,5]. Low- and middle-income countries have experienced disproportionately high amounts of productivity loss, incidence, and mortality of women due to breast cancer [1, 3, 4]. In 2018, the global estimate of newly diagnosed breast cancer cases among women totaled 2.1 million. The economic and social burden that breast cancer places on societies has propelled research that analyzes the role of modifiable risk factors as the primary prevention methods. This review aimed to synthesize evidence on the cost-effectiveness of lifestyle-related interventions for the primary prevention of breast cancer in order to answer the question on whether implementing interventions focused on behavior changes are worth the value for money
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