The Financial Cost of Preventive and Curative Programs for Breast Cancer: A Case Study of Women in Shiraz-Iran

Document Type : Original Article

Authors

1 School of Health Administration and Medical Information, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

3 Griffith Health Institute, Griffith University, QLD, Australia

Abstract

Background
This cross-sectional study was conducted to compare the average costs of breast cancer screening and treatment among women with the age of 25 and over in Shiraz-Iran.
 
Methods
Three majors hospitals affiliated with Shiraz University of Medical Sciences (SUMS) were selected for data collection. Financial documents and interviews with the hospitals’ financial officers were used for data collection.
 
Results
Finding shows that the total cost of screening would be 5,847,544.96 US dollars for age groups of 25–34 and 35 and above, demonstrating the huge expense of screening programs. On the other hand, the average cost of breast cancer treatment for each patient would be 3608.47, 996.89, and 311.47 US dollars for mastectomy, radiotherapy, and chemotherapy, respectively. In addition, the total average cost for treatment of 2217 patients would be 1,466,988.9 US dollars, which is much less than screening programs expenses.
 
Conclusion
It is concluded that although screening can be effective for improving quality of life and treatment effectiveness, considering the high costs of screening, it is not economical in Iran. Screening methods within suitable intervals, and also considering patients’ medical history have been recommended by the present study.

Keywords

Main Subjects

References

  1. Micheli A, Coebergh JW, Mugno E, Massimiliani E, Sant M, Oberaigner W, et al.  European heath systems and cancer care.  Ann Oncol 2003; 14: 41–60.
  2. Mohaghegh FA, Hamta A, Shariat Zade SA. [Investigation of current cancers in Markazi province and its registration system in 2001-2006 in compare with country statistics]. Journal of Arak University of Medical Sciences 2008; 11: 84–94.
  3. Akbari ME, Naghavi M. [Economical burden of cancers in Iran]. Daroo and darman Journal 2009; 67: 51–6.
  4. Hatam N, Ahmadloo N, Ahmad Kia Daliri A, Bastani P, Askarian M. Quality of life and toxicity in breast cancer patients using adjuvant TAC (docetaxel, doxorubicin, cyclophosphamide), in comparison with FAC (doxorubicin, cyclophosphamide, 5-fluorouracil). Arch Gynecol Obstet  2011; 284: 215–20. doi: 10.1007/s00404-010-1609-8
  5. Yen JY, Ko CH, Yen CF, Yang MJ, Wu CY, Juan CH, et al. Quality of life, depression, and stress in breast cancer women outpatients receiving active therapy in Taiwan. Psychiatry Clin Neurosci  2006; 60: 147–53. doi: 10.1111/j.1440-1819.2006.01479.x
  6. Bland KI, Sarr MG, Buchler MW, Csendes A, Garden OJ, Wong  J. General Surgery: Principles and International Practice. Australia: Springer; 2010.
  7. Phipps WJ, Long BC, Woods N. Medical-surgical nursing: concepts and clinical practice. 5th ed. St. Louis, MO: Mosby; 1995.
  8. Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi I, Najafi M, et al. Breast Cancer in Iran: an epidemiological review. Breast J 2007; 13; 383–91. doi: 10.1111/j.1524-4741.2007.00446.x
  9. Gholikhani R, Sadrmomtaz N. [Health cost analysis]. 1st ed. Tehran: Debizesh publication; 2001.
  10. Nouroozi T, Salehi A. Prime costs of clinical laboratory services in Tehran Valiasr Hospital in 2009. EMHJ 2013; 19: 159–65.
  11. Hatam N, Bastani P, Ahmadloo N, Kiadaliri AA. Health Related Quality of Life in Breast Cancer Patients Undergoing Current Chemotherapy Protocols. Kerman University of Medical Sciences Journal 2011; 19: 37–46.
  12. Phipps WJ, Long BC, Woods N. Medical-surgical nursing. 7th ed. St. Louis, MO: Mosby; 2003.
  13. Andersen R, Hager M. Analysis of the cost-effectiveness of mammography promotion by volunteers in rural communities. Health Educ Behav 2002; 29: 755-70. doi: 10.1177/109019802237942
  14. Zwahlen M, Probst N, Baschung B, de Wolf C, Marty-Tschumi  E, Borisch B. Early detection of breast cancer using mammography-a position paper of the Swiss Cancer League [internet]. 2003. Swiss Cancer League. Available from: http://assets.krebsliga.ch/downloads/pospap_final_kls_en_.pdf
  15.  Risenquist J, Lindfors K. Screening mammography in women aged 40-49 years: analysis if cost-effectiveness. Radiology 1994; 191: 647–50.
  16. Lebovic GS, Hollingsworth A, Feig SA. Risk assessment, screening and prevention of breast cancer: A look at cost-effectiveness. Breast 2010; 19: 260–7. doi: 10.1016/j.breast.2010.03.013
  17. Pisati G, Cerri S, Marinelli M, Tedeschi B, Valsecchi E. [Cancer screening programme in health care workers]. G Ital Med Lav Ergon 2011; 33: 57–60.
  18. Hadi N, Sadeghi-Hassanabadi A, Talei AR, Arasteh MM, Kazerooni T. Assessment of a breast cancer screening programme in Shiraz, Islamic Republic of Iran. East Mediterr Health J 2002; 8: 386–92.
  19. Grann VR, Patel PR, Jacobson JS, Warner E, Heitjan DF, Ashby-Thompson M, et al. Comparative effectiveness of screening and prevention strategies among BRCA1/2-affected mutation carriers. Breast Cancer Res Treat 2011; 125: 837–47. doi: 10.1007/s10549-010-1043-4
  20. Smith RA. Cancer screening in the USA. J Med Screen 2006; 13: 48–53.
  21. Mehrabani D, Tabei SZ, Heydari ST, Shamsina SJ, Shokrpour N, Amini M, et al. Cancer Occurrence in Fars Province, Southern Iran. Iran Red Crescent Med J 2008; 10: 314–22.  
  22. Schousboe JT, Kerlikowske K, Loh A, Cummings SR. Personalizing mammography by breast density and other risk factors for breast cancer: analysis of health benefits and cost-effectiveness. Ann Intern Med 2011; 155: 10–20. doi: 10.7326/0003-4819-155-1-201107050-00003
  23. Boer R, de Koning H, Threlfall A, Warmerdam P, Street A, Friedman E, et al. Cost effectiveness of shortening screening interval in extending age range of NHS breast screening programme: computer simulation study. BMJ 1998; 317: 376-9. doi: 10.1136/bmj.317.7155.376
  24. Stout NK, Rosenberg MA, Trentham-Dietz A, Smith MA, Robinson SM, Fryback DG. Retrospective cost-effectiveness analysis of screening mammography. J Natl Cancer Inst 2006; 98: 774–82. doi: 10.1093/jnci/djj210
  25. Peregrino AA, Vianna CM, de Almeida CE, Gonzáles GB, Machado SC, Costa e Silva FV, et al. [Analysis of Cost-effectiveness of screening for breast cancer with conventional mammography, digital and magnetic resonance imaging]. Cien Saude Colet 2012; 17: 215–22.
  26. Verbeek AL, van Dijck JA, Kiemeney LA, Broeders MJ. Responsible cancer screening. Ned Tijdschr Geneeskd 2011; 155: A3934.

 

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History

  • Receive Date: 14 January 2014
  • Revise Date: 08 May 2014
  • Accept Date: 04 May 2014
  • First Publish Date: 04 May 2014

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