HEA008 Cancer (all types) screenings leading to increased quality-adjusted life years (QALY)

Number of individuals screened: Reported by program.

Percentage of participants who are screened solely because of the program:

We use screening rates from the Minnesota Health Care programs for low-income as counterfactual baselines for different types of cancer (MHCP, n/d):

• Breast cancer: [0.38], estimated as (1-Screening rate). Screening rate in MN = 0.62
• Cervical cancer: [0.20], estimated as (1-Screening rate). Screening rate in MN = 0.80
• Colorectal cancer: [0.44], estimated as (1-Screening rate). Screening rate in MN = 56%

QALY increase:

• Biopsy – [0.11]. This is the value of a biopsy screening, based on research from the Center for the Evaluation of Value and Risk in Health, Tufts Medical Center (n.d.).
• Breast cancer – [0.01]. This is the value for breast cancer screening compared with no screening (Mittmann et al., 2018).
• Cervical cancer – [0.01]. This is the value of cervical cancer screening compared with no screening (Mandelblatt et al., 2002).
• Colon cancer – [0.05]. This is the value for colon cancer screening with colonoscopy compared with no screening (Tafazzoli, Roberts, Ness & Dittus, 2005).
• Prostate cancer – [0.04]. This is the value for prostate cancer screening (Heijnsdijk et al, 2015). Note: Tis counterfactual valid only for older adults.

$ value per QALY: [$50,000]

Benefits are then discounted to present value based on the average age of participation to life expectancy.

Heijnsdijk, E. a. M., de Carvalho, T. M., Auvinen, A., Zappa, M., Nelen, V., Kwiatkowski, M., … de Koning, H. J. (2015). Cost-effectiveness of prostate cancer screening: a simulation study based on ERSPC data. Journal of the National Cancer Institute, 107(1), 366.

Mandelblatt, M., Lawrence, W., Womack, S., Yi, B., Jacobsen, D., Hwang, Y., Gold, K., Barter, J. & Shah, K. (2002). Benefits and costs of using HPV testing to screen for cervical cancer. Journal of the American Medical Association, 287(18), 2372-2381.

Minnesota Health Care Programs (MHCP), (n/d) Retrieved from: https://www.health.state.mn.us/diseases/cancer/sage/about/facts.html

Mittmann, N., Stout, N. K., Tosteson, A. N. A., Trentham-Dietz, A., Alagoz, O., & Yaffe, M. J. (2018). Cost-effectiveness of mammography from a publicly funded health care system perspective. CMAJ Open, 6(1), E77–E86.

Tafazzoli, A., Roberts, S., Ness, R. & Dittus, R. (2005). A comparison of screening methods for colorectal cancer using simulation modeling. In M. E. Kuhl, N. M. Steiger, F. B. Armstrong & J. A. Jones (Eds.), Proceedings of the 2005 Winter Simulation Conference. Piscataway, NJ: Institute of Electrical and Electronics Engineers.

Minnesota Department of Health (2017). Quick facts: Cancer screening in Minnesota. Retrieved from: http://www.health.state.mn.us/divs/healthimprovement/data/quick-facts/screening.html