Table 5b Comparison of the UK’s screening strategy as implemented in the United Kingdom

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)

684±12

552±18

748±11

670±12

545±15

755±9

Tumours detected

731±21

624±18

781±25

715±16

618±21

781±16

Interval cancers

144±13

241±14

114±9

146±13

241±15

101±10

Tumours diagnosed before start of screening

37±8

76±8

41±7

16±4

37±6

17±4

Tumours diagnosed after end of screening

83±8

100±10

54±5

110±13

129±7

64±9

Mammography examinations in hospital ( × 1000)

19.0±0.4

15.2±0.1

24.7±0.3

21.1±0.3

16.6±02

27.4±0.4

Mammography examinations in NBSP ( × 1000)

0.7±0.1

2.2±0.1

N.A.

0.9±0.1

2.7±0.1

N.A.

MRI examinations ( × 1000)

23.4±0.4

15.1±0.1

24.2±0.3

25.7±0.3

16.5±0.2

26.8±0.4

False-positive mammographies

909±21

778±25

1.097±21

1.015±33

871±27

1.222±33

False-positive MRIs

3.134±79

2.035±28

3.273±62

3.457±59

2.245±49

3.624±77

Years of life gained (years per woman)a

1.625

1.368

1.628

1.231

1.077

1.231

Additional costs ( × 1000 per woman)b

2.153

1.454

2.350

2.339

1.588

2.550

Additional costs per life-year gained compared with the UK strategy ( × 1000 per year per woman)

2.7

—

3.4

4.9

—

6.2

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