Cost-Effectiveness Analysis of a Mobile Mammography Unit for Breast Cancer Screening to Reduce Geographic and Social Health Inequalities

Mil, Rémy De; Guillaume, Élodie; Launay, Ludivine; Guittet, Lydia; Dejardin, Olivier; Bouvier, Anne–Marie; Notari, Annick; Launoy, Guy; Berchi, Célia

doi:10.1016/j.jval.2019.06.001

Cited by 14 publications

(8 citation statements)

References 32 publications

(40 reference statements)

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“…21 In addition, mobile screening units demonstrated cost-effectiveness in increasing cancer screening rates, especially among underserved populations. [22][23][24][25] Collaboration with mobile screening units can expand access to cancer screening in low-resource settings.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Cancer Screening Delays

Zhang

Elsaid

DeGraffinreid

et al. 2023

JCO

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PURPOSE To examine delays in cancer screenings during the COVID-19 pandemic. METHODS Participants from previous studies (N = 32,989) with permissions to be recontacted were invited to complete a survey between June and November 2020. Participants (n = 7,115) who met the age range for cancer screenings were included. Participants were asked if they planned to have and then if they postponed a scheduled mammogram, Pap test, stool blood test, colonoscopy, or human papillomavirus (HPV) test. Logistic regression was used to determine the factors associated with cancer screening delays for each planned test. RESULTS The average age was 57.3 years, 75% were female, 89% were non-Hispanic White, 14% had public insurance, and 34% lived in rural counties. Those who planned cancer screenings (n = 4,266, 60%) were younger, more likely to be female, with higher education, had private insurance, and lived in rural counties. Specifically, 24% delayed a mammogram (n = 732/2,986), 27% delayed a Pap test (n = 448/1,651), 27% delayed an HPV test (n = 59/220), 11% delayed a stool blood test (n = 44/388), and 36% delayed a colonoscopy (n = 304/840). Age, race/ethnicity, education, and health insurance were associated with delays in cancer screenings (all P < .05). Compared with non-Hispanic White women, non-Hispanic Black women had lower odds of delaying a mammogram (odds ratio [OR], 0.60; 95% CI, 0.39 to 0.94), Hispanic women had higher odds of delaying Pap test (OR, 2.46; 95% CI, 1.34 to 4.55), and women with other race/ethnicity had higher odds of delaying both Pap test (OR, 2.38; 95% CI, 1.41 to 4.02) and HPV test (OR, 5.37; 95% CI, 1.44 to 19.97). CONCLUSION Our findings highlighted the urgency for health care providers to address the significant delays in cancer screenings in those most likely to delay. Strategies and resources are needed to help those with barriers to receiving guideline-appropriate cancer screening.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Cancer Screening Delays

Zhang

Elsaid

DeGraffinreid

et al. 2023

JCO

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“…Breast cancer is the most common cancer among women, with psychological, occupational and social consequences. [ 12 ] This prospective, cross-sectional study was to evaluate the preoperative stress levels in patients undergoing breast cancer surgery. Diagnosis and treatment, as well as the consequences on women's everyday life, are often severe.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Preoperative Anxiety Levels in Patients Undergoing Breast Cancer Surgery

Katsohiraki

Poulopoulou

Fyrfiris

et al. 2020

Asia-Pacific Journal of Oncology Nursing

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Objective: Patients' anxiety and stress levels are increased after the surgery. High levels of anxiety and stress could increase postoperative complications, as well as to prolong postoperative hospitalization and postoperative morbidity. This prospective, cross-sectional study was to evaluate the preoperative stress levels in patients undergoing breast cancer surgery. Methods: In the study participated 165 female patients who underwent breast cancer surgery, in a major oncological hospital in Greece. Demographic and clinical data were collected, and anxiety and stress levels assessed using the State-Trait Anxiety Inventory (STAI) Scale, which was a self-report questionnaire consisting of 40, 4 Likert Scale questions. The first 20 questions, STAI-X-1, were concerned to how the patient felt while answering the questionnaire (anxiety as a condition) and the remaining 20 questions, STAI-X-2, based on how the patient felt overall (stress as a personality trait). Descriptive statistics and nonparametric tests were performed at a significance level alpha = 0.05. Results: In the present study, 165 females were enrolled who underwent breast cancer surgery. The mean age of the participants was 55.86 years, whereas the mean body mass index was 26.85. The 60.6% of patients underwent a lumpectomy and 28.5% had mastectomy. The 35.8% experienced moderate levels of anxiety, and the 17.6% experienced high levels. The two scales were positively correlated (rho = 0.643, P < 0.001), at the significance level P = 0.01. Furthermore, the Stai-X-2 Scale was negatively correlated with body height (rho = −0.1188, P = 0.016). Conclusions: The present study showed that patients' personality influenced their anxiety levels. Thus, the role of the nurse is a cornerstone in their psychological support preoperatively, to reduce the anxiety and stress levels.

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“… 26 Therefore, organized screening programs may have the potential to eliminate at least some barriers encountered by disadvantaged women and reduce inequities. 31 , 32 Assuming that mobile mammography units help to increase participation, 33 – 36 we showed that this strategy would be cost-effective in regions with low screening adherence. Moreover, earlier studies 33 showed that decreasing geographical barriers is also an effective measure for decreasing social inequalities in participation in breast cancer screening for the total population.…”

Section: Discussionmentioning

confidence: 86%

Overcoming barriers: Modelling the effect of potential future changes of organized breast cancer screening in Italy

et al. 2023

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Objectives Organized breast cancer screening may not achieve its full potential due to organizational and cultural barriers. In Italy, two identified barriers were low attendance in Southern Italy and, in Italy as a whole, underscreening and overscreening in parts of the eligible population. The objective of this study was to identify potential changes to overcome these barriers and to quantify their costs and effects. Methods To assess the impact of potential measures to improve breast cancer screening in Italy, we performed an evaluation of costs and effects for increasing adherence for Southern Italy and harmonizing screening intervals (biennial screening) for the whole of Italy, using an online tool (EU-TOPIA evaluation tool) based on the MIcrosimulation SCreening ANalysis (MISCAN) model. Results Increasing adherence in Southern Italy through investing in mobile screening units has an acceptable cost-effectiveness ratio of €9531 per quality-adjusted life year gained. Harmonizing the screening interval by investing in measures to reduce opportunistic screening and simultaneously investing in mobile screening units to reduce underscreening is predicted to gain 1% fewer life-years, while saving 19% of total screening costs compared to the current situation. Conclusions Increasing adherence in Southern Italy and harmonizing the screening interval could result in substantial improvements at acceptable costs, or in the same benefits at lower costs. This example illustrates a systematic approach that can be easily applied to other European countries, as the online tools can be used by stakeholders to quantify effects and costs of a broad range of specific barriers, and ways to overcome them.

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Cost-Effectiveness Analysis of a Mobile Mammography Unit for Breast Cancer Screening to Reduce Geographic and Social Health Inequalities

Cited by 14 publications

References 32 publications

Impact of the COVID-19 Pandemic on Cancer Screening Delays

Impact of the COVID-19 Pandemic on Cancer Screening Delays

Evaluating Preoperative Anxiety Levels in Patients Undergoing Breast Cancer Surgery

Overcoming barriers: Modelling the effect of potential future changes of organized breast cancer screening in Italy

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