The costs of mammography screening in New Zealand: evidence from the pilot programmes.

AIMS

To measure the public health service costs associated with New Zealand's pilot mammography screening programmes. To compare the early evidence on cost per woman screened and per cancer detected in those programmes to that of overseas screening programmes. To estimate the cost of introducing a national screening programme in New Zealand.

METHODS

Costs in each screening centre were obtained by a careful examination of screening budgets and public health service accounts; these were inflation adjusted using a consumers price index, and analysed in terms of equivalent annual operating costs.

RESULTS

In the first year of screening the cost per woman screened (in $1991) was $182 in Waikato and $178 in Otago/Southland. The cost per woman screened in the third year of screening (with an assumed full screening throughput of 8,000 women per annum) is estimated to fall to $106 and $113 for the Waikato and Otago/Southland programmes respectively. The cost per cancer detected in the first screening round differs between the two programmes. In the first year of screening the cost per cancer detected was $35,975 in Waikato and $21,908 in Otago/Southland. The difference was primarily attributable to a lower cancer detection rate in Waikato in that period (0.51% of women screened compared with 0.81% in Otago/Southland).

CONCLUSIONS

The initial performance of the New Zealand pilot programmes, both in terms of cost per woman screened and cost per cancer detected, falls within the range indicated from overseas experience. An established national screening programme is estimated to add between $9.3 and $9.9 million dollars (in 1991 dollar terms) to health service costs each year. These costs will be partly offset by savings resulting from the earlier detection of cancers.