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Anticipating the Consequences for the Primary Therapy of Breast Cancer after Introducing Screening: A More Global Picture for Health Care Policy Making

Published online by Cambridge University Press:  10 March 2009

Josep M. Borràs
Affiliation:
Catalan Institute of Oncology and Catalan Agency for Health Technology Assessment
Josep A. Espinas
Affiliation:
Catalan Institute of Oncology
Petra M. M. Beemsterboer
Affiliation:
Erasmus University
Alicia Granados
Affiliation:
Catalan Agency for Health Technology Assessment
Harry J. De Koning
Affiliation:
Erasmus University

Abstract

A breast cancer screening program mainly aims at reducing mortality. However, it also has an effect, often not assessed, on the utilization of health care resources that is relevant to health care policy making. Using a simulation model, this paper forecasts the impact of introducing a breast cancer screening program on the utilization of resources for the primary therapy of breast cancer. The most important consequences from a health care point of view will be an increased use of breast-conserving therapy and an increased need for postoperative radiotherapy; there will also be a higher number of women diagnosed with noninvasive breast cancer. The results of this study could provide support for health care decision making by showing the consequences of policy decisions on the introduction of screening programs for health care utilization.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1998

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References

REFERENCES

1.Almazán, C., Borràs, J. M., de la Puente, M. L., et al. Aproximación a la utilizatión de la mamografia de cribado en dos regiones sanitarias [Utilization patterns of mammography screening in two health regions, Catalonia (Spain)]. Atención Primaria, 1995, 15, 452–56.Google Scholar
2.Ascunze, N., del Moral, A., Murillo, A., et al. Early detection programme for breast cancer in Navarra, Spain. European Journal of Cancer Prevention, 1994, 3, 4148.CrossRefGoogle Scholar
3Ascunze, N., González, J., & González, A., et al. Criterios generales y recomendaciones para la elaboratión de programas de detectión precoz de cáncer de mama y cáncer de cérvix uterino en España (Criteria and general recommendations on breast and cervical cancer screening in Spain). Revista de Sanidad y Higiene Pública, 1993, 67, 2337.Google Scholar
4.Beemsterboer, P. M. M., de Koning, H. J., Warmerdam, P. G., et al. Prediction of the effects and costs of breast-cancer screening in Germany. International Journal of Cancer, 1994, 58, 623–28.CrossRefGoogle ScholarPubMed
5.Borràs, J. M., (ed.). El cribratge del càncer de mama a Catalunya: Cost-efectivitat, impacte assistencial i cost del tractament del càncer de mama. [Breast cancer screening in Catalonia: Cost-effectiveness, health care impact and cost of the treatment of breast cancer]. Barcelona: Agència d'Avalaució de Tecnologia Mèdica, Institut Catalá d'Oncologia, 1996.Google Scholar
6.Borràs, J. M., Borràs, J., Bosch, F. X., & Viladiu, P. (eds.). Epidemiologia y prevención del cancer en Cataluña (1975–1992) [Epidemiology and prevention of cancer in Catal (1975–1992)]. Barcelona: Institut Català d’Oncologia, 1996.Google Scholar
7.Borràs, J. M., Ciurana, R., & Marzo, M.Cribado del càncer de mama [Breast cancer screening]. Medicina Clinica (Barcelona), 1994, 102(suppl. 1), 7579.Google Scholar
8.Borràs, J. M., Gómez, X., Serra, L. L., & Granados, A.Programa de prevenció i control del càncer a Catalunya [The cancer control and prevention programme in Catalonia] [Catalan]. Salut Catalunya, 1991, 5, 7684.Google Scholar
9.Borràs, J. M., & Iglesias, X.Cribado del cancer de cuello uterino [Cervical cancer screening]. Medicina Clinica (Barcelona), 1994, 102(suppl. 1), 8084.Google Scholar
10.Collette, H. J. A., Day, N. E., Rombach, J. J., & Waard, F.Evaluation of screening for breast cancer in a non-randomised study (the DOM project) by means of a case-control study. Lancet, 1984, 1, 1224–26.CrossRefGoogle Scholar
11.de Koning, H. J., Boer, R., Warmerdam, P. G., et al. Quantitative interpretation of agespecific mortality reductions from the Swedish Breast Cancer-Screening trials. Journal of the National Cancer Institute, 1995, 87, 1217–23.CrossRefGoogle ScholarPubMed
12.de Koning, H. J., Dongen, J. A., & van der Maas, P. J.Changes in use of breast-conserving therapy in years 1978–2000. British Journal of Cancer, 1994, 70, 1165–70.CrossRefGoogle ScholarPubMed
13.de Koning, H. J., van Ineveld, B. M., van Oortmarssen, G. J., et al. Breast cancer screening and cost-effectiveness: Policy alternatives, quality of life considerations and the possible impact of uncertain factors. International Journal of Cancer, 1991, 49, 531–37.CrossRefGoogle ScholarPubMed
14.de Koning, H. J., van Oortmarssen, G. J., van Ineveld, B. M., & van der Maas, P. J.Breast cancer screening: Its impact on clinical medicine. British Journal of Cancer, 1990, 61, 292–97.CrossRefGoogle ScholarPubMed
15.Hailey, D. M.The influence of technology assessment by advisory bodies on health policy and practice. Health Policy, 1993, 25, 243–54.CrossRefGoogle ScholarPubMed
16.Hailey, D. M. The perspective of the policy maker on health care research and evaluation. In Dafy, J., Mcdonald, I., & Willis, E., (eds.), Researching health care. London: Rontledge, 1992, 1520.Google Scholar
17.Izquierdo, A., Viladiu, P., Borràs, J., et al. El riesgo del càncer de mama en Cataluña [Risk of breast cancer in Catalonia, Spain]. Medicina Clinica (Barcelona), 1996, 107, 410–13.Google Scholar
18.Izquierdo, A., Viladiu, P., Borràs, J.M., et al. La perceptión de las causas del càncer y de su prevención en las mujeres de Girona [Perception of the cause of cancer and its prevention among women from Girona, Spain]. Medicina Clinica (Barcelona), 1996, 107, 1419.Google Scholar
19.Marzo, M.Anàlisi del cribratge del càncer de mama en el nostre entorn [Analysis of breast cancer screening in our context] [tesi doctoral]. Barcelona: Universitat Autònoma de Barcelona, 1995.Google Scholar
20.Mayer, W. J., & Beardall, R. W. Translating science into practice: Cancer prevention in primary care medicine. In Greenwald, P., Kramer, B. S., & Weed, D. L., (eds.), Cancer prevention and control. New York: Marcel Dekker, Inc, 1995, 411–33.Google Scholar
21.Nyström, L., Rutqvist, L. E., Wall, S., et al. Breast cancer screening with mammography: Overview of Swedish randomised trials. Lancet, 1993, 341, 973–78.CrossRefGoogle ScholarPubMed
22.Paci, E., Boer, R., Zappa, M., et al. A model-based prediction of the impact on reduction in mortality by a breast cancer screening programme in the city of Florence, Italy. European Journal of Cancer, 1995, 3, 348–53.CrossRefGoogle Scholar
23.Parkin, D. M., Muir, C. S., Whelan, S. L., et al. (eds.). Cancer incidence in five continents. VI. Lyon: International Agency for Research on Cancer, 1992.Google ScholarPubMed
24.U.S. Preventive Services Task Force. Guide to clinical preventive services, 2nd ed.Baltimore: Williams & Wilkins, 1996.Google Scholar
25.van Oortmarssen, G. J., Habbema, J. D. F., van der Maas, P. J., et al. A model for breast cancer screening. Cancer, 1990, 66, 1601–12.3.0.CO;2-O>CrossRefGoogle Scholar
26.Verbeek, A. L. M., Hendriks, J. H. C. L., Holland, R., et al. Reduction of breast cancer mortality through mass screening with modern mammography: First results of the Nijmegen project, 1975–1981. Lancet, 1984, 1, 1222–24.CrossRefGoogle ScholarPubMed
27.Viladiu, P., Izquierdo, A., Beltran, M., et al. Epidemiologia del càncer ginecològic i de mama a l'Area Sanitària de Girona [Epidemiology of breast and gynecologic cancer in Girona, 1980–1989]. Girona: Registre del Càncer de Girona i Associació Espanyola contra el Càncer, 1995.Google Scholar