THE SOCIAL FINANCIAL LOAD OF OPPORTUNISTIC SCREENING OF BREAST CANCER

Abstract

The study was carried out concerning complex evaluation of financial load of opportunistic screening of breast cancer. The data of established cases of breast cancer and stages of disease are taken from collections "The state of oncologic care in Russia" 2014, 2015 and 2016. The financial expenses for implementation of analog mammography, sonography and physician's examination are taken from "The territorial tariff agreement 2014". The evaluation of X-ray finds was implemented using categories BI-RADS (Breast Imaging Reporting and Data System) proposed by the American College of Radiology. During 2014, in the Primorskiy Krai 40,825 of diagnostic and 50,824 cases of preventive mammography were implemented. In 2015 43,196 diagnostic and 58,567 preventive examinations and in 2016 47,359 diagnostic and 53 973 preventive examinations were implemented correspondingly. According the Foundation of mandatory medical insurance, the price of analog mammography made up to 292 rubles. The social financial load of diagnostic of a single case of breast cancer at stage T1 made up to 96,367 rubles in 2014, 90,966 rubles in 2015 and 73,303 rubles in 2016 correspondingly. The analysis of detection of breast cancer at early stage T1 and financial costs of early diagnostic demonstrated a distinct trend of decreasing of financial load at diagnostic of a single case of breast cancer of T1 during 2014-2016 at the expense of amelioration of quality of description of picture and training of radiologists. The model was proposed to form groups of higher risk with subsequent detailed examination and implementation of opportunistic screening in the group of common level of risk of development of breast cancer as a most perspective and less unprofitable one.