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Low-Income Women's Cancer Screenings Cost Effective: Report
Date:12/21/2007

Total cost about $555, government analysis shows.,,

FRIDAY, Dec. 21 (HealthDay News) -- Screening tests for breast and cervical cancer for under- or uninsured low-income U.S. women cost about $150 annually per woman screened, according to a new government analysis.

The total cost per woman each year, including administrative, quality assurance, education and outreach is about $555, according to the analysis of the National Breast and Cervical Cancer Early Detection Program.

"This program basically does more than just screening -- it also provides funds for outreach, data collection, quality assurance, professional development, case management and evaluation," said one of the study's authors, James Gardner, a public health analyst at the U.S. Centers for Disease Control and Prevention.

The cost of treating a cancer detected by this screening program averaged $10,566 for breast cancer and $13,340 for cervical cancer.

"The thing you can take away from this study is that you can actually penetrate into a group of uninsured people, provide the care, get them into the system and treat them in a very cost-effective manner," said Dr. Otis Brawley, chief medical officer for the American Cancer Society. "This program is doing a world of service, and this is a government program that needs to be expanded, not contracted."

This cost analysis comes on the heels of another study from the American Cancer Society that found women who are uninsured are more likely to die from cancer than are women with health insurance. Just 10 percent to 15 percent of privately insured women are diagnosed with late-stage (stage III or IV) breast cancer, compared to 20 percent to 30 percent of women who lack health insurance, that study reported Thursday.

It's not clear from the new analysis what the cost-savings might be if women who were screened were compared to women who weren't screened and were later found to have cancer. But, Brawley said, the potential for health-care savings is enormous. He said that women who don't get screened will likely not be diagnosed until they have a much more advanced cancer. "They end up so sick that somebody ends up giving them health care, and, at that point, it's a lot more expensive," he said.

Results of the analysis are published in the Feb. 1, 2008, issue of the journal Cancer.

"It's society's decision about what we want to spend on prevention and screening," said Dr. Julia Smith, director of the Lynne Cohen Breast Cancer Preventive Care Program at New York University Cancer Institute and Bellevue Hospital.

"If you diagnose at stage 0 or an early stage 1, you're talking about surgery, and you may be talking about radiation or hormone therapy," Smith said. "But the big savings come from the fact that early detection may prevent recurrences. Those recurrences cost a fortune and are technically not curable. There are patients that may have a long run, but you're treating the whole time and will have spent many hundreds of thousands of dollars."

The new analysis included information from nine of the 68 National Breast and Cervical Cancer Early Detection programs (NBCCEDP) across the United States. Data was collected from July 2003 through June 2004. The researchers hoped to be able to quantify the program's costs to be able to better allocate limited resources and to assist the state programs in planning and implementing cost-effective activities.

The researchers found that almost 60 percent of the programs' resources was spent on screening and diagnostic follow-up. The remaining 40 percent was spent on non-screening activities, such as public education and outreach, data collection and management, professional education and quality assurance.

The average cost of breast cancer screening alone was $94, according to the analysis. The average cost of screening for cervical cancer was $56.

The analysis authors wrote that this information will "provide a framework for establishing the minimum number of NBCCEDP-eligible women who can be screened given the resources available."

More information

To learn more about the National Breast and Cervical Cancer Early Detection Program and to find out if you qualify for low-cost services or free services, visit the U.S. Centers for Disease Control and Prevention.



SOURCES: James Gardner, M.S.P.H., public health analyst, U.S. Centers for Disease Control and Prevention, Atlanta; Julia Smith, M.D., Ph.D., director, Lynne Cohen Breast Cancer Preventive Care Program, New York University Cancer Institute and Bellevue Hospital, New York City; Otis Brawley, M.D., chief medical officer, American Cancer Society, Atlanta; Feb. 1, 2008, Cancer


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