Resumo

GONZALEZ-MARINO, Mario A. Evaluating the usefulness of a breast screening program in Bogotá, Colombia. Rev. salud pública [online]. 2012, vol.14, n.1, pp.41-52. ISSN 0124-0064.

Objective Using a simulation model for evaluating the usefulness of an organized breast cancer screening program in Bogotá, Colombia Material and methods The Markov model was used for designing a cost-effectiveness analysis; this was compared to a biennial breast cancer screening for women aged 50 to 69 years old. The disease's natural history, breast screening studies and publications concerning breast cancer were used as input for the model; the number of diagnosed cancer cases, stage distribution and mortality, survival, costs and increased effectiveness rate were also analyzed. Results The model showed that breast cancer mortality rate decreased in biennial breast cancer screening. Life-years-gained became increased from the third cycle onwards. The ratio between the cost of a life-year-gained and gross domestic product was lower than 3 when more than 50 % of the population were screened (meaning that such program would be cost-effective). The program's lowest average cost was achieved by increasing the number of screening cycles as far as the sixth cycle. Conclusions The simulation model for studying the impact of changing a breast cancer screening program's coverage for women aged 50 to 69 years led to ascertaining that introducing biennial frequency would be cost-effective when more than 50 % of the population were studied. A lower mortality rate would result, mainly from the third cycle onwards, thereby saving important health system resources in Bogotá, Colombia.

Palavras-chave : Cost effectiveness; analysis; breast; breast neoplasm; mammography; preventative; control.

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