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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Annals of oncology 9 (1998), S. 613-618 
    ISSN: 1569-8041
    Keywords: colorectal cancer ; screening ; health economy ; cost-effectiveness
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Today, only carcinoma of the bronchus kills more people thancolorectal cancer (CRC). However, CRC is both preventable and curable. InNorway, projects aiming to detect adenomas and early cancers by thescreening of a population aged about 60 years employing sigmoidoscopy havebeen discussed. Materials and methods: In this study, a mathematical model was used toestimate the cost-effectiveness of a screening programme for colorectalpolyps followed by polypectomy. A once-only sigmoidoscopy at age 60 followedby coloscopy in selected risk groups was suggested. Data from theEnglish-language literature, the National Cancer Registry of Norway, andStatistics Norway were included. Norwegian cost data from the NationalHealth Administration were also used. Costs of screening and those relatedto earlier diagnosis, and savings on health care and averted loss inproduction due to prevented CRCs were calculated. Results: The basic cost per patient invited and screened (70%compliance) in the suggested programme was estimated at £81.7 and£116.7, respectively. When gains due to prevented CRCs were included,the figures became £34.5 and £49.2. The cost per life-year savedwas calculated as £2,889. This strongly indicates that screening forthe early detection and prevention of CRC is one of the most cost-effectiveprogrammes in cancer. Conclusions: CRC screening according to the suggested programme appears tobe cost-effective. Clear evidence that screening can reduce mortality from CRCshould convince health-care policy makers that the time has come to encouragescreening for colorectal cancer.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Annals of oncology 10 (1999), S. 197-203 
    ISSN: 1569-8041
    Keywords: breast cancer ; cost-effectiveness ; mammography ; screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Mammography screening is a promising method for improving prognosis in breast cancer. Patients and methods: In this economic analysis, data from the Norwegian Mammography Project (NMP), the National Health Administration (NMA) and the Norwegian Medical Association (NMA) were employed in a model for cost-effectiveness analysis. According to the annual report of the NMP for 1996, 60,147 women aged 50–69 years had been invited to a two-yearly mammographic screening programme. 46,329 (77%) had been screened and 337 (0.7%) breast cancers had been revealed. The use of breast conserving surgery (BCS) was in this study estimated raised by 17% due to screening, the breast cancer mortality decreased by 30% and the number of life years saved per prevented breast cancer death was calculated 15 years. Results: The cost per woman screened was calculated £75.4, the cost per cancer detected £10,365 and the cost per life year (LY) saved £8,561. A raised frequency of BCS, diagnosis and adjuvant chemotherapy brought two years forward, follow-up costs and costs/savings due to prevented breast cancer deaths were all included in the analysis. A sensitivity analysis documented mammography screening cost-effective in Norway when four to nine years are gained per prevented breast cancer death. Conclusion: Mammography screening in Norway looks cost- effective. Time has come to encourage national screening programmes.
    Type of Medium: Electronic Resource
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