Table 5a Comparison of the Dutch screening strategy as implemented in NL

From: Which screening strategy should be offered to women with BRCA1 or BRCA2 mutations? A simulation of comparative cost-effectiveness

Genetic mutation

BRCA1

BRCA2

Screening strategy

NL

UK

US

NL

UK

US

Small tumours detected (<2 cm)

750±11

663±15

799±11

777±12

696±11

821±13

Tumours detected

791±23

717±22

838±24

814±17

749±15

851±18

Interval cancers

88±11

153±12

59±6

61±5

119±9

32±5

Tumours diagnosed before start of screening

42±6

73±11

43±7

16±3

36±5

17±4

Tumours diagnosed after end of screening

26±6

30±5

N.A.

27±5

30±4

N.A.

Mammography examinations in hospital ( × 1000)

18.9±0.5

15.2±0.4

24.5±0.4

21.1±0.3

16.7±0.2

27.4±0.3

Mammography examinations in NBSP ( × 1000)

1.0±0.1

3.2±0.2

N.A.

1.2±0.1

3.9±0.1

N.A.

MRI examinations ( × 1000)

23.2±0.5

15.1±0.2

23.9±0.3

25.6±0.3

16.6±0.1

26.8±0.3

False-positive mammographies

904±36

831±30

1.081±28

1.033±46

939±34

1.231±38

False-positive MRIs

3.139±86

2.033±48

3.231±71

3.448±38

2.249±40

3.624±74

Years of life gained (years/woman)a

1.614

1.366

1.620

1.217

1.077

1.221

Additional costs ( × €1000 per woman)b

2.292

1.572

2.555

2.511

1.743

2.786

Additional costs per life-year gained compared with NL strategy ( × €1000 per year per woman)

—

2.9c

43.8

—

5.5c

68.8

  1. Abbreviations: MRI=magnetic resonance imaging; N.A.=not applicable; NBSP=National Breast Cancer Screening Program; NL=The Netherlands
  2. Comparison of the Dutch screening strategy as implemented in NL, with the British (UK) and American (US) screening strategy when implemented in NL, assuming simultaneous application of the Dutch NBSP. Average values of absolute numbers±s.d. per 1000 women with a BRCA1 or BRCA2 genetic mutation.
  3. aReference is Dutch NBSP.
  4. bAdditional costs with reference to Dutch NBSP, all cost estimates based on Dutch prices.
  5. cSavings: programme is less expensive and adds less life-years gained with respect to the Dutch strategy.
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