Cost implications of routine mammography screening of women 50-69 years in the County of Funen, Denmark

In order to estimate the net costs of introducing mammography screening to women 50-69 years of age, unit costs of all relevant activities related to detection and treatment of breast cancer were estimated using activity based costing methods. In order to determine the overall impact of mammography screening, activity data collected from the second screening round (1996-1997) were compared with expected activity levels in the case no screening had taken place in this time period. The direct health care costs associated with the screening activity, excluding effects on treatment and diagnostics but including women's transport and time costs, were estimated at DKK 305 per attendee. The cost of clinical mammography decreases with the introduction of screening due to a decrease in the total number of women undergoing this introductory diagnostic activity, while surgery costs increases, whereas cost incurred by adjuvant treatment and treatment of recurrences will be significantly reduced. Overall, inclusion of effects on course of treatment decreases the net cost of screening by 30-40% to DKK 208 and DKK 128 including and excluding the women's time and transport costs, respectively. (C) 2000 Elsevier Science Ireland Ltd.