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Digital Mammography Screening Not Cost Effective

Models show using all-digital mammography doesn't warrant cost; targeting digital images to younger women might

THURSDAY, Jan. 3 (HealthDay News) -- Compared to film mammography, screening all women for breast cancer with digital mammography isn't cost effective. However, targeting digital mammography use on younger women appears to be cost effective, according to research published in the Jan. 1 issue of the Annals of Internal Medicine.

Anna N.A. Tosteson, of Dartmouth Medical School in Lebanon, N.H., and colleagues used findings from the Digital Mammography Imaging Screening Trial (DMIST) and other data to create a simulation model that would project the possible effect of different screening strategies. The options they considered were film mammography for all women; digital for all women; digital for women under 50; or digital for women under 50 or older women with dense breasts.

All-digital mammography cost was found to be $331,000 per quality-adjusted life-year (QALY) gained relative to all-film mammography screening. Targeted digital screening led to more cancer detection and fewer cancer deaths than all-film or all-digital screening, with cost per QALY gained ranging from $26,500 for age-targeted digital mammography, up to $84,500 for age- and density-targeted digital mammography.

"This analysis has policy relevance for insurers who must decide whether the higher costs of digital mammography screening are justified by improved health outcomes. On the basis of DMIST findings, our analysis indicates that digital mammography screening does not result in sufficient health gains to warrant its increased cost unless its use is limited to younger women," the authors write.

One co-author works for a university offering digital mammography, has consulted for Dartmouth, and received grants from the American College of Radiology Imaging Network. Another works for a university that receives research support from GE.

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