James G. Gardner

Estimated effects of the National Breast and Cervical Cancer Early Detection Program on breast cancer mortality.

BACKGROUND The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast cancer screening to medically underserved, low-income women aged 40-64 years. No study has evaluated NBCCEDPs effect on breast cancer mortality. PURPOSE This study estimates life-years saved by NBCCEDP breast cancer screening compared with screening in the absence of NBCCEDP and with no screening. METHODS A breast cancer simulation model based on existing Cancer Intervention and Surveillance Modeling Network models was constructed. The screening module from these models was modified to reflect screening frequency for NBCCEDP participants. Screening data for uninsured women represented what would have happened without the program. Separate simulations were performed for women who received NBCCEDP (Program) screening, women who potentially received screening without the program (No Program), and women who received no screening (No Screening). The impact of NBCCEDP was estimated as the difference in life-years between the Program and No Program, and the Program and No Screening scenarios. The analysis was performed in 2008-2009. RESULTS Among 1.8 million women who were screened between 1991 and 2006, the Program saved 100,800 life-years compared with No Program and 369,000 life-years compared with No Screening. Per woman screened, the Program saved 0.056 life-years (95% CI=0.031, 0.081) compared with No Program and 0.206 life-years (95% CI=0.177, 0.234) compared with No Screening. Per woman with invasive breast cancer and screen-detected invasive cancer, the Program saved 0.41 and 0.71 life-years, respectively, compared with No Program. CONCLUSIONS These estimates suggest that NBCCEDP breast cancer screening has reduced mortality among medically uninsured and underinsured low-income women.

Cost Analysis of the National Breast and Cervical Cancer Early Detection Program : Selected States, 2003 to 2004

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) was established by the U.S. Congress in 1990. In recent years, there has been an emphasis on ascertaining the NBCCEDPs costs of delivering screening and diagnostic services to medically underserved, low‐income women. The objective of this report was to address 3 economic questions: What is the cost per woman served in the program, what is the cost per woman served by program component, and what is the cost per cancer detected through the program?

Cost of cervical cancer treatment: implications for providing coverage to low-income women under the Medicaid expansion for cancer care.

BACKGROUND To date, no study has reported on the cost of treating cervical cancer among Medicaid beneficiaries younger than 65 years of age. This information is essential for assessing the cost effectiveness of screening interventions for low-income women and the funding required for treatment programs established by the Breast and Cervical Cancer Prevention and Treatment Act of 2000. METHODS Administrative data from the North Carolina Medicaid program linked with cancer registry data were used to analyze total Medicaid costs for these patients and the incremental costs of cervical cancer care at 6 and 12 months from diagnosis. We compared 207 beneficiaries diagnosed with cancer during the years 2002 to 2004 with 414 controls. FINDINGS Total Medicaid costs at 6 months after diagnosis were

Developing and Testing a Cost-Assessment Tool for Cancer Screening Programs

3,807,

Cost analysis of the national breast and cervical cancer early detection program - Selected states, 2003 to 2004: Selected States 2003-2004

23,187,

Cost of breast cancer treatment in Medicaid: implications for state programs providing coverage for low-income women.

35,853, and

The impact of a national program to provide free mammograms to low‐income, uninsured women on breast cancer mortality rates

45,028 for in situ, local, regional, and distant cancers, respectively. The incremental cost of cancer treatment for local and regional cancers was

When performance management works: A study of the National Breast and Cervical Cancer Early Detection Program

13,935 and

Identifying and controlling for program-level differences in comparative cost analysis: Lessons from the economic evaluation of the National Breast and Cervical Cancer Early Detection Program

26,174 and by 12 months increased to

Estimating personal costs incurred by a woman participating in mammography screening in the National Breast and Cervical Cancer Early Detection Program.

15,868 and