Document Type : Review Article
Professor, Department of Health Management and Economics Sciences, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Professor, Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
Professor, Department of Surgery, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
PhD of Health Management, Department of Health Management and Economics, School of public Health, Tehran University of Medical Sciences, Tehran, Iran.
Introduction: Breast cancer is one of the most common cancers and a leading cause of death worldwide and in Iran. Mammography is commonly used in breast cancer screening and diagnosis. This study was performed with aim to evaluate the efficacy and cost-effectiveness of mammography, especially the mobile type, in breast cancer screening in Iran.
Methods: This study is an overview of reviews. After a systematic search in the databases of Cochrane Library, Trip, Pubmed, CRD and magiran, the appropriate, relevant and up-to-date reports including systematic review, health technology assessment, economic assessment and clinical guidance were found and used.
Results: Mammography sensitivity for breast cancer screening in fixed type was reported between 84% and 96% and in mobile type between 77% and 98%. Its specificity has been reported between 50% and 100% in fixed type and between 92% and 95% in mobile type. In Iran, the use of mammography in the screening program increases the cost by about $ 37,000 per QALY (quality adjusted life years).
Conclusion: Due to the incidence of the disease, mammography is not cost effective in breast cancer screening, although in certain communities, for example, with a relatively high incidence may be cost effective. Mobile mammography is usually more expensive than fixed mammography and its technical performance is not much different, so it may be less cost effective than fixed mammography.