Menon A, Devlin N J, Richardson A K
Department of Preventive and Social Medicine, University of Otago, Dunedin.
N Z Med J. 1994 Dec 14;107(991):501-3.
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.
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.
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).
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.
衡量与新西兰乳房X线筛查试点项目相关的公共卫生服务成本。将这些项目中每位接受筛查的女性以及每例检测出癌症的成本的早期证据与海外筛查项目进行比较。估计在新西兰引入全国性筛查项目的成本。
通过仔细审查筛查预算和公共卫生服务账目来获取每个筛查中心的成本；使用消费价格指数对这些成本进行通胀调整，并按等效年度运营成本进行分析。
在筛查的第一年，怀卡托地区每位接受筛查的女性的成本（以1991年美元计）为182美元，奥塔哥/南地地区为178美元。估计在筛查第三年（假设每年完全筛查量为8000名女性），怀卡托和奥塔哥/南地项目每位接受筛查的女性成本将分别降至106美元和113美元。在第一轮筛查中，两个项目检测出每例癌症的成本有所不同。在筛查的第一年，怀卡托地区检测出每例癌症的成本为35975美元，奥塔哥/南地地区为21908美元。差异主要归因于该时期怀卡托地区较低的癌症检测率（接受筛查的女性中有0.51%检测出癌症，而奥塔哥/南地地区为0.81%）。
新西兰试点项目在每位接受筛查的女性成本和检测出每例癌症的成本方面的初步表现，处于海外经验所示的范围内。估计一个既定的全国性筛查项目每年将使卫生服务成本增加930万至990万美元（以1991年美元计）。这些成本将因癌症早期检测带来的节省而部分抵消。
