Early detection of breast cancer has proven to be cost-effective for the Canadian healthcare system

Early detection of breast cancer has proven to be cost-effective for the Canadian healthcare system

Cancer screenings are key to saving patients' lives because earlier diagnosis improves survival rates, reduces morbidity and leads to less intensive treatments. Early detection also has the potential to save the Canadian healthcare system a lot of money. The United States has introduced breast cancer screening for women in their 40s because the incidence of breast cancer among younger women is increasing. Current research from the University of Ottawa confirms this increase.

Lead author Dr. Anna Wilkinson, an associate professor at the University of Ottawa (uOttawa) School of Medicine and a general practitioner at the Ottawa Hospital (TOH) Cancer Center and with a team of uOttawa researchers including Drs. Jean Seely and TOH – including Dr. Moira Rushton, a medical oncologist at the Ottawa Hospital Cancer Center – collaborated with the Sunnybrook Research Institute to study the cost-effectiveness of earlier-stage breast cancer treatments.

Dr. Wilkinson gave us an overview of this work, published inJAMA:

Question: What are the proven benefits of early detection of breast cancer?
Anna Wilkinson:“When breast cancer is detected at an early stage, less intensive treatments may be used, such as lumpectomies instead of mastectomies, single (sentinel) node biopsies instead of removing all lymph nodes in the armpit, and often avoiding chemotherapy and radiation therapy.

“Survival for breast cancer depends on the stage at diagnosis: the 5-year net survival rate for stage I breast cancer is 100 percent, which subsequently drops to 92%, 74%, and 23% for stage II, III, and IV breast cancers, respectively.”

Q: Why was it important to review the cost of screening now?
RE:"The recent debate over whether women ages 40 to 49 should be screened for breast cancer has highlighted the importance of understanding the economics of screening. In examining this issue, we found that cost-effectiveness analyzes are outdated and do not reflect expensive new advances in the standard of care."

Q: What are the latest advances and why has cost effectiveness not been taken into account?
RE:"In recent years there has been an explosion of exciting innovations in breast cancer treatment that have led to improved breast cancer survival rates. These treatment successes are leading to rapidly increasing costs for advanced breast cancer. For example, new targeted therapies for high-risk patients." Stage II and III hormone-sensitive breast cancer can cost nearly $142,000 over two years and over $210,000 over three years in the metastatic state. A Highly Potent Antibody-Drug Conjugate for HER2-Positive and HER2-Poor Breast Comes with a Cost From $166,000 for a year of therapy and immunotherapy for triple-negative breast cancer, the cost for a year of therapy in stage IV can rise to over $500,000.

"Traditional cost models use population-level databases, which have inherent time lags in data availability and do not reflect rapidly evolving costs. Our cost calculations were unique in that all costs along the breast cancer continuum were included, such as: diagnosis, pathology, radiology, surgery." ; radiation oncology; hospitalization; palliative care costs;

Q: What savings do you expect?
RE:"We found that screening a cohort of women aged 40 to 74 years for breast cancer annually saved the Canadian healthcare system $459.6 million over the lifetime of these women, with 3,499 breast cancer deaths averted and 52,367 years of life gained. This represents a savings of $1." ,880 US dollars for each woman examined. The cost of mammography screening and diagnostics can easily be offset by treating cancers at earlier stages more cheaply.”

Q: What impact could an early detection policy have for breast cancer and other diseases?
RE:"At a time when we will continue to see increasingly expensive and rapidly evolving cancer treatments, early diagnosis of cancer is a cost-saving measure. We should view this study as a call for similar analyzes of the cost-effectiveness of colorectal cancer screening." Evidence of cost savings in cancer screening could address the health disparities created by various cancer screening practices across Canada. while improving cancer morbidity and mortality.”

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