Butler J R, Furnival C M, Hart R F
National Centre for Epidemiology and Population Health, Australian National University, Canberra.
Aust N Z J Surg. 1995 Jul;65(7):485-91. doi: 10.1111/j.1445-2197.1995.tb01791.x.
The aim of the study was to determine if there is a relationship between the stage of breast cancer at the time of detection and the costs of treatment and to assess whether any such relationship would have an influence on the cost of a mammographic screening programme. A retrospective analysis of the stage at presentation for primary breast cancer and the treatment costs over the duration of treatment was made. Multiple regression analysis was employed, with treatment cost as the dependent variable and categorical variables to represent stage at detection. A total of 301 women whose treatment for breast cancer commenced at the Royal Brisbane Hospital participated in the study. A statistically significant relationship was found between the stage of disease at the time of detection and subsequent treatment costs; more advanced stages of disease incurred higher treatment costs. This relationship was robust even after taking into account the age of patients, their discharge status, and differences between patients in the duration of treatment. When the effect of earlier detection on treatment cost was assessed in relation to a breast screening programme, cost savings were estimated to be in the range of 8-36% of total screening costs. There are treatment cost savings to be gained from breast cancer screening as a result of the detection of earlier stages of disease. These treatment cost savings should be offset against the cost of a mammographic screening programme.
该研究的目的是确定乳腺癌在被发现时的分期与治疗费用之间是否存在关联，并评估这种关联是否会对乳房X光筛查项目的成本产生影响。对原发性乳腺癌确诊时的分期以及整个治疗期间的治疗费用进行了回顾性分析。采用多元回归分析，将治疗费用作为因变量，用分类变量表示发现时的分期。共有301名在皇家布里斯班医院开始接受乳腺癌治疗的女性参与了该研究。研究发现，发现疾病时的分期与后续治疗费用之间存在统计学上的显著关联；疾病分期越晚，治疗费用越高。即使考虑到患者的年龄、出院状态以及患者之间治疗时长的差异，这种关联依然稳固。当评估早期发现对乳房筛查项目治疗费用的影响时，估计成本节约幅度在总筛查成本的8%至36%之间。通过发现疾病的早期阶段，乳腺癌筛查能够节省治疗费用。这些治疗费用的节省应与乳房X光筛查项目的成本相抵消。
