Low-Income Women's Cancer Screenings Cost Effective: Report

FRIDAY, Dec. 21 (HealthDay News) -- Screening tests for breast andcervical cancer for under- or uninsured low-income U.S. women cost about$150 annually per woman screened, according to a new governmentanalysis.
The total cost per woman each year, including administrative, qualityassurance, education and outreach is about $555, according to the analysisof the National Breast and Cervical Cancer Early Detection Program.
"This program basically does more than just screening -- it alsoprovides funds for outreach, data collection, quality assurance,professional development, case management and evaluation," said one of thestudy's authors, James Gardner, a public health analyst at the U.S.Centers for Disease Control and Prevention.
The cost of treating a cancer detected by this screening programaveraged $10,566 for breast cancer and $13,340 for cervical cancer.
"The thing you can take away from this study is that you can actuallypenetrate into a group of uninsured people, provide the care, get theminto the system and treat them in a very cost-effective manner," said Dr.Otis Brawley, chief medical officer for the American Cancer Society."This program is doing a world of service, and this is a governmentprogram that needs to be expanded, not contracted."
This cost analysis comes on the heels of another study from theAmerican Cancer Society that found women who are uninsured are more likelyto die from cancer than are women with health insurance. Just 10 percentto 15 percent of privately insured women are diagnosed with late-stage(stage III or IV) breast cancer, compared to 20 percent to 30 percent ofwomen who lack health insurance, that study reported Thursday.
It's not clear from the new analysis what the cost-savings might be ifwomen who were screened were compared to women who weren't screened andwere later found to have cancer. But, Brawley said, the potential forhealth-care savings is enormous. He said that women who don't getscreened will likely not be diagnosed until they have a much more advancedcancer. "They end up so sick that somebody ends up giving them healthcare, and, at that point, it's a lot more expensive," he said.
Results of the analysis are published in the Feb. 1, 2008, issue of thejournal Cancer.
"It's society's decision about what we want to spend on prevention andscreening," said Dr. Julia Smith, director of the Lynne Cohen BreastCancer Preventive Care Program at New York University Cancer Institute andBellevue Hospital.
"If you diagnose at stage 0 or an early stage 1, you're talking aboutsurgery, and you may be talking about radiation or hormone therapy," Smithsaid. "But the big savings come from the fact that early detection mayprevent recurrences. Those recurrences cost a fortune and are technicallynot curable. There are patients that may have a long run, but you'retreating the whole time and will have spent many hundreds of thousands ofdollars."
The new analysis included information from nine of the 68 NationalBreast and Cervical Cancer Early Detection programs (NBCCEDP) across theUnited States. Data was collected from July 2003 through June 2004. Theresearchers hoped to be able to quantify the program's costs to be able tobetter allocate limited resources and to assist the state programs inplanning and implementing cost-effective activities.
The researchers found that almost 60 percent of the programs' resourceswas spent on screening and diagnostic follow-up. The remaining 40 percentwas spent on non-screening activities, such as public education andoutreach, data collection and management, professional education andquality assurance.
The average cost of breast cancer screening alone was $94, according tothe analysis. The average cost of screening for cervical cancer was$56.
The analysis authors wrote that this information will "provide aframework for establishing the minimum number of NBCCEDP-eligible womenwho can be screened given the resources available."