Screening mammography in women aged 40-49 years: Analysis of cost-effectiveness

PURPOSE: To evaluate the cost-effectiveness of screening mammography in women 40-49 years old. MATERIALS AND METHODS: A Markov model compared two hypothetical groups; one underwent screening mammography and the other, observation without mammography. Variables tested included frequency of mammography, reduction in breast cancer mortality, and cost-effectiveness by age group. Results were expressed as marginal cost per year of life saved. RESULTS: If the estimated mortality reduction from mammographic screening was 15% or greater, the marginal cost per year of life saved was comparable to that of other generally accepted medical procedures. Annual screening with an assumed 30% reduction in mortality had a cost-effectiveness similar to that of biennial screening with a 20% reduction. Screening mammography was less cost-effective in the 40-49-year-old age group than in women aged 50-79 years but more cost-effective than in those aged 80-84 years. CONCLUSION: Although the parameters for screening mammography in women aged 40-49 years are not known with certainty, the results of this analysis may help establish priorities for utilization of medical resources.