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Background <p>There is limited evidence on the optimal frequency of mammogram surveillance. At 5-year follow-up, the Mammo-50 trial found that, in patients aged 50+ and 3 years post diagnosis, less frequent mammograms were non-inferior to annual mammograms for breast-cancer-specific-survival, recurrence-free interval and overall survival.</p> Methods <p>A within-trial cost-effectiveness analysis compared annual versus less frequent mammogram surveillance over 5 years from healthcare and societal perspectives. Hospital Episodes Statistics captured hospital-based resource use. Health-related quality of life and other cost data were obtained via questionnaires at surveillance mammograms. A budget impact analysis estimated NHS savings.</p> Results <p>Less frequent surveillance led to cost savings of −£543.88 (−£1116; £26) and a small reduction in quality-adjusted life years (QALYs) of −0.02 (−0.095; 0.06) per patient. The incremental net monetary benefit at a £20,000/QALY threshold was £187 (−£1574; £2027). Including societal costs increased savings to £1543 per person (−£2416; −£669), and cost-effectiveness. Projected NHS savings were £185.87 million over 6 years.</p> Conclusion <p>Less frequent mammogram surveillance is cost-effective. Uncertainty remains due to variability in costs and quality of life estimates, and missing data in the less frequent arm due to study design. Given the trial’s non-inferiority findings, this strategy is recommended from healthcare and societal perspectives.</p>

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Annual versus less frequent mammographic surveillance in people with breast cancer aged 50 years and older in the UK (Mammo-50): cost-effectiveness and budget impact analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月6日

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  • Paola Cocco,
  • Chris Bojke,
  • Claire Hulme,
  • Peter S. Hall,
  • Amy Hopkins,
  • Andrea Marshall,
  • Janet A. Dunn,
  • David Meads,
  • Bethany Shinkins

摘要

Background

There is limited evidence on the optimal frequency of mammogram surveillance. At 5-year follow-up, the Mammo-50 trial found that, in patients aged 50+ and 3 years post diagnosis, less frequent mammograms were non-inferior to annual mammograms for breast-cancer-specific-survival, recurrence-free interval and overall survival.

Methods

A within-trial cost-effectiveness analysis compared annual versus less frequent mammogram surveillance over 5 years from healthcare and societal perspectives. Hospital Episodes Statistics captured hospital-based resource use. Health-related quality of life and other cost data were obtained via questionnaires at surveillance mammograms. A budget impact analysis estimated NHS savings.

Results

Less frequent surveillance led to cost savings of −£543.88 (−£1116; £26) and a small reduction in quality-adjusted life years (QALYs) of −0.02 (−0.095; 0.06) per patient. The incremental net monetary benefit at a £20,000/QALY threshold was £187 (−£1574; £2027). Including societal costs increased savings to £1543 per person (−£2416; −£669), and cost-effectiveness. Projected NHS savings were £185.87 million over 6 years.

Conclusion

Less frequent mammogram surveillance is cost-effective. Uncertainty remains due to variability in costs and quality of life estimates, and missing data in the less frequent arm due to study design. Given the trial’s non-inferiority findings, this strategy is recommended from healthcare and societal perspectives.