Cost Effectiveness Analysis Of Breast Cancer Screening In Upper-And Low-Middle Income Countries, Focusing On Egypt: A Systematic Review

Abstract

Background Breast cancer is the leading cause of death among women. Screening using mammography is proposed as an effective intervention for reducing early deaths due to breast cancer. Aim of the study to assess the cost-effectiveness of different screening programs in upper and low-middle income economies. Methods We conducted a systematic review, we searched pub-med, Google Scholar, Cochrane and Embase with related search words. We screened the titles and abstracts for relevancy. Our searches yielded 366, after initial screenings and assessments, we excluded (228 studies excluded by title being irrelevant such as breast cancer treatment or awareness program), we assessed the abstracts of 121
articles and excluded 80 articles (including 7 systematic review studies), then reviewing the full-texts of 41 studies and finally we included Fourteen studies that met the minimum inclusion criteria. Results The majority of these studies were of poor-quality regarding cost calculation, breast cancer incidence among different age groups, mortality rate of breast cancer. Studies demonstrated the cost-effectiveness of breast cancer screening strategies. Conclusions This review shows that the evidence base to guide strategies for breast cancer control in upper and low-middle income countries are limited and of poor quality. There is very little evidence to provide specific recommendations on screening by mammography versus clinical breast examination, the frequency of screening, or the target population.