Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women

Breast cancer is the second most common cancer in the world and, by far, the most frequent cancer among women with an estimated 1.67 million new cancer cases diagnosed in 2012 (25% of all cancers). It is the most common cancer in women both in more and less developed regions with slightly more cases in less developed (883,000 cases) than in more developed (794,000) regions. Incidence rates vary nearly four-fold across the world regions, with rates ranging from 27 per 100,000 in Middle Africa and Eastern Asia to 96 in Western Europe. We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer. This study is an economic evaluation of mammography screening program among Iranian woman aged 40-70 years. A decision tree and Markov model were developed to estimate total Quality Adjusted Life Years (QALY) and lifetime costs. The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int.$37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int.$ 141,641 and Int.$389,148 respectively. The first round mammography screening program was cost-effective in 53% of the cases, but the Incremental cost per QALY in the second and third rounds of screening were much higher than the accepted level of payment of the Iran's health system,