This project will determine the cost-effectiveness and cost-utility of the interventions developed and implemented in Project 1 - Coordinating Community Resources to Promote Participation in Breast Screening. The costs of Project 2, Enhancing BSE Maintenance through Self-Reward Strategies, will be included in Project l's costs. Four outcomes will be examined to assess the incremental cost-effectiveness and cost-utility of the programs in each of the intervention communities compared to the control community: life-years gained, quality adjusted life-years gained; the number of deaths averted per 100,000 women; and the number of earlier breast cancers (local stage) diagnosed per 100,000 women. Breast cancer incidence, stage and mortality will be obtained from the Biometry Core. The costs of implementing and maintaining the intervention programs will be obtained from the Administrative and Community Cores. The costs of screening and the costs induced by screening, for evaluation, treatment, follow-up and terminal care of breast cancer, for death from other causes, for lost time and lost earnings, will be obtained prospectively for randomly selected women in each of the communities. Health status and quality of life will be measured for women with breast cancer and women with benign breast disease using three available instruments. Sensitivity analyses will examine the effect of a range of discount rates, estimates of life expectancy, utility values, charges for screening procedures, and costs induced by screening.
Showing the most recent 10 out of 20 publications
