Cost-effectiveness analysis of a prospective breast cancer screening program in Turkey

Thesis Type: Postgraduate

Institution Of The Thesis: Middle East Technical University, Turkey

Approval Date: 2011

Thesis Language: English

Student: Engin Astım

Supervisor: EBRU VOYVODA


Cancer is the second leading cause of death among the world and it has an increasing share among all causes of death. Economical burden of cancer is increasing especially in high and middle-income countries. Leaving cancer in competitive markets would lead to inefficiencies; hence governments should intervene in the market and make public decisions in struggling cancer. Among all cancer types breast cancer has the highest incidence and mortality rates in females. Causes of breast cancer still remains indeterminate and only way to cope with breast cancer are by early diagnoses. Early diagnoses can best be achieved by regular mammography screenings. This study analyzes the possible outcomes of implementing regular breast cancer mammography screening program in Turkey. A simulation model is constructed and run for 10 years, to obtain the costs and benefits of such a screening program. Costs of such a program include the screening costs and costs due to abnormal mammograms. Benefits, on the other hand are reduced treatment costs due to early diagnosis, reduced mortality and morbidity. Simulation model is run for 11 different screening strategies for determining the optimal screening strategy in terms of screening interval and minimum age to screen. The necessary data is obtained from hospital records, Cancer Early Diagnosis and Treatment Center records, IMF, WHO and TUIK databases and literature. Results of the simulation suggest that women over 40 in Turkey should be screened biennially for economical efficiency.