Peregrino Antonio Augusto de Freitas, Vianna Cid Manso de Mello, de Almeida Carlos Eduardo Veloso, Gonzáles Gabriela Bittencourt, Machado Samara Cristina Ferreira, Costa e Silva Frances Valéria, Rodrigues Marcus Paulo da Silva
Laboratório de Ciências Radiológicas, Universidade do Estado do Rio de Janeiro, Maracanã, Rio de Janeiro 20550-900.
Cien Saude Colet. 2012 Jan;17(1):215-22. doi: 10.1590/s1413-81232012000100023.
A cost-effectiveness analysis was conducted in screening for breast cancer. The use of conventional mammography, digital and magnetic resonance imaging were compared with natural disease history as a baseline. A Markov model projected breast cancer in a group of 100,000 women for a 30 year period, with screening every two years. Four distinct scenarios were modeled: (1) the natural history of breast cancer, as a baseline, (2) conventional film mammography, (3) digital mammography and (4) magnetic resonance imaging. The costs of the scenarios modeled ranged from R$ 194.216,68 for natural history, to R$ 48.614.338,31, for screening with magnetic resonance imaging. The difference in effectiveness between the interventions ranged from 300 to 78.000 years of life gained in the cohort. The ratio of incremental cost-effectiveness in terms of cost per life-year gains, conventional mammographic screening has produced an extra year for R$ 13.573,07. The ICER of magnetic resonance imaging was R$ 2.904.328,88, compared to no screening. In conclusion, it is more cost-effective to perform the screening with conventional mammography than other technological interventions.
对乳腺癌筛查进行了成本效益分析。将传统乳腺钼靶检查、数字乳腺摄影和磁共振成像的使用与自然疾病史作为基线进行了比较。一个马尔可夫模型对一组10万名女性在30年期间的乳腺癌情况进行了预测，每两年进行一次筛查。模拟了四种不同的情况：(1) 乳腺癌的自然病史，作为基线；(2) 传统胶片乳腺钼靶检查；(3) 数字乳腺摄影；(4) 磁共振成像。所模拟情况的成本从自然病史的194,216.68雷亚尔到磁共振成像筛查的48,614,338.31雷亚尔不等。各干预措施之间的有效性差异在该队列中为获得的300至78,000年生命之间。就每生命年收益的成本而言，增量成本效益比方面，传统乳腺钼靶筛查每多获得一年生命需花费13,573.07雷亚尔。与不进行筛查相比，磁共振成像的增量成本效益比为2,904,328.88雷亚尔。总之，与其他技术干预措施相比，采用传统乳腺钼靶检查进行筛查更具成本效益。
