Cost Effectiveness in Screening Policies for Breast Cancer in the Presence of Over-diagnosis
Open Access
Author:
Chawaranggoon, Chanyakan
Area of Honors:
Industrial Engineering
Degree:
Bachelor of Science
Document Type:
Thesis
Thesis Supervisors:
Dr. Paul M Griffin, Thesis Supervisor Dr. Paul M Griffin, Thesis Honors Advisor M Jeya Chandra, Faculty Reader
Keywords:
breast cancer screening over-diagnosis cost effectiveness QALY TreeAge Pro
Abstract:
Although breast cancer screening can help reduce the rate of mortality and morbidity, it can also
cause harm when there is a presence of over-diagnosis. Over-diagnosis is a medical term, recently used in the healthcare field, indicating harm that is caused by screening mammography. This study aims to explore the issue of breast cancer screening policies in the presence of over-diagnosis and to determine an optimal policy in each scenario. Sensitivity analysis over a range of over-diagnosis rates between 0% and 50%, starting ages between 35 to 50, and screening intervals between 1 year and 5 years is conducted
using a Markov chain and decision tree model of breast cancer screening. TreeAge Pro 2013 software
was used to perform the analysis. The method incorporates Monte Carlo simulation as well as cost
effectiveness analysis with the purpose of determining a recommended policy in breast cancer screening. Quality adjusted life years (QALYs), number of mammograms, and cumulative screening costs were also
determined.
