Table 3 Screening and diagnostic work up cost and utility parameters
Cluster | Study | Cost of screening in 2014 USD over lifetime (in risk group) | Utility loss from screening (%) | Additional imaging | Biopsy | |||
|---|---|---|---|---|---|---|---|---|
Probability of false positive | Diagnostic recall in 2014 USD | Probability of biopsy | Diagnostic biopsy in 2014 USD | Utility loss from work up | ||||
Screening in general population | [12] | Low: $812 Moderate: $3822 | Not included | They combine imaging and biopsy | 3.1–9.1% | $360 | 0–0.013 for 1 year | |
[16] | Low:$ 2652 Moderate: $5304 | 0.6% for 1 week | n.a. | $131 | n.a. | $863 | 10.5% for 5 weeks | |
[14] | Low: $1972 Moderate: $3393 | 0.6% for 1 week | n.a. | $135 | n.a. | $889 | 10.5% for 5 weeks | |
[17] | Low: $1104 Average: $1656 Moderate: $3312 | 0.6% for 1 week | n.a. | $141.42 | 10.6% | $1354–$1442 depending on age | 10.5% for 5 weeks | |
[15] | Low: $2840 Moderate: $4480 | Not included | 6.3–6.8%a | SFM: $65 DM: $95 US: $58 | 6.3–6.8%a | FNA: $377 CNB: $290–$933 Surgical: $1402–$1700 | Not included | |
[13] | Lowe: $247 Average: $377 Moderate: $1248 | Not included | 2.8% | SFM: $34 US: $442 | 0.26% | $701 | 0.013 for 1 year | |
Screening in high risk population | [19] | $19,382 | Not included | 13.5% DM | DM: $166 | 2.95% | $636 | Not included |
[22] | $14,060 | DM: 0–10% for 1 week MRI: 0–20% for 1 week | 5.59% SFM + US b | DM: $125 US: $83 | 0.52% | CNB: $795–$1420 Surgical: $2397–$2499 | 0–30% for 2 weeks | |
[21] | $20,550 | 1% for 1 year | They combine imaging and biopsy | 5.4–10.8% | $503 | 11% for 1 year | ||
[23] | $5945 | Not included | n.a. | MRI: $258 US: $56 | n.a. | Biopsy: $276 | Not included | |
[24] | $31,635 | SFM: 0–10% for 1 week MRI: 0–20% for 1 week | 3–8% | SFM: $68 US: $53 | 0.3–0.8% | CNB: $662–$1302 Surgical: $1550–$1646 | 0–30% for 2 weeks | |
[25] | $7659 | 0% | They combine imaging and biopsy | n.a. | $135 | 1.3% for 1 year | ||
[20] | $1276 | 0% | They combine imaging and biopsy | 4.3–8.2% | $125 | 0.6% for 1 year | ||
[26] | $17,613 | 0–5% for 1 year | 7% SFM + US | SFM: $64 US: $58 MRI: $649 | 1.6% | FNA: $382 CNB: $432–$792 Surgical: $1040–$1383 | 0–17% for 1 week | |
[27] | $927 | Not included | 19% SFM + US | SFM: $64 US: $58 MRI: $649 | 7.2% | FNA: $382 CNB: $432–$792 Surgical: $1040 | Not included | |
Screening after risk assessment | [31] | Test: $916 Low: $2765 High: $24,325 | Not included | 23% SFM + US | $251 | 9.6% | n.a. | Not included |
[29] | Test: $101 Low risk: $0 High: $14,800 | Not included | Not included | |||||
[28] | Test: $276 Low: n.a. High: $24,140 | Not included | Not included | |||||