Ekwueme Donatus U, Gardner James G, Subramanian Sujha, Tangka Florence K, Bapat Bela, Richardson Lisa C
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Atlanta, Georgia 30341, USA.
Cancer. 2008 Feb 1;112(3):626-35. doi: 10.1002/cncr.23207.
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) was established by the U.S. Congress in 1990. In recent years, there has been an emphasis on ascertaining the NBCCEDP's costs of delivering screening and diagnostic services to medically underserved, low-income women. The objective of this report was to address 3 economic questions: What is the cost per woman served in the program, what is the cost per woman served by program component, and what is the cost per cancer detected through the program?
The authors developed a questionnaire to systematically collect activity-based costs on screening for breast and cervical cancer from 9 participating programs. The questionnaire was developed based on well established methods of collecting cost data for program evaluation. Data were collected from July 2003 through June 2004.
With in-kind contributions, the cost of screening services to women in 9 programs was estimated at $555 per woman served. Without in-kind contributions, this cost was $519. Among the program components, screening and coalitions/partnerships accounted for the highest and lowest cost per woman served, respectively. The median cost of screening a woman for breast cancer was $94, and the cost per breast cancer detected was $10,566. For cervical cancer, these costs were $56 and $13,340, respectively.
Costs per woman served, screened, and cancers detected are needed for programs to accurately determine the resources required to reach and screen eligible women. With limited program resources, these cost estimates can provide useful information to assist programs in planning and implementing cost-effective activities that could maximize the allocation of program resources.
美国国会于1990年设立了国家乳腺癌和宫颈癌早期检测项目（NBCCEDP）。近年来，人们一直强调确定NBCCEDP为医疗服务不足的低收入女性提供筛查和诊断服务的成本。本报告的目的是解决三个经济问题：该项目中每位受服务女性的成本是多少，每个项目组成部分服务每位女性的成本是多少，以及通过该项目检测出的每例癌症的成本是多少？
作者设计了一份问卷，以系统地收集来自9个参与项目的乳腺癌和宫颈癌筛查基于活动的成本。该问卷是根据为项目评估收集成本数据的成熟方法制定的。数据收集时间为2003年7月至2004年6月。
计入实物捐赠后，9个项目中为女性提供筛查服务的成本估计为每位受服务女性555美元。不计实物捐赠时，这一成本为519美元。在项目组成部分中，筛查以及联盟/伙伴关系分别占每位受服务女性成本的最高和最低份额。筛查一名女性患乳腺癌的成本中位数为94美元，每例检测出的乳腺癌成本为10,566美元。对于宫颈癌，这些成本分别为56美元和13,340美元。
各项目需要了解每位受服务女性、接受筛查女性以及检测出癌症患者的成本，以便准确确定为符合条件的女性提供服务和进行筛查所需的资源。在项目资源有限的情况下，这些成本估计可为协助项目规划和开展具有成本效益的活动提供有用信息，从而最大限度地分配项目资源。
