The Cost and Outcomes of Breast Cancer Screening for Women 40-49 Years Old in Russia

Abstract

In Russia screening for breast cancer (BC) is recommended for women 39-75 years old, though WHO recommends starting BC screening at the age of 50 in the limited resource settings. To assess the cost and outcomes of BC screening in women 40-49 years old in Russia. Using published data on BC screening in Russia, we estimated the number of women, who underwent screening in 2014 in age groups 40-49 and 50-69 and respective number of BC cases detected. Also for every age group we calculated expected numbers of false positive results based on published data on sensitivity and specificity of mammography. Costs of screening were estimated using the average public health insurance tariffs for mammography in the frames of screening and biopsy. In 2014 1.72 million women underwent screening in the age group 40-49, with the total cost of screening €6.01 million and 1,287 BC cases detected. In the age group 50-69 3.74 million women were screened, total cost of screening was €12.8 million and 5,568 BC cases were diagnosed. Thus, the average cost of BC case detected was €4,671 in age group 40-49 and €2,298 in age group 50-69. The number of false positive results of mammography per BC case detected was also twice higher in age group 40-49 than in 50-69 years old – 45 vs 21. BC screening in the age group 40-49 results not only in higher cost per BC case detected, but also in higher numbers of false positive results, thus questioning the expected benefits of existing screening program for the society.