PMID- 22809238
OWN - NLM
STAT- MEDLINE
DCOM- 20121120
LR  - 20220318
IS  - 1365-3156 (Electronic)
IS  - 1360-2276 (Linking)
VI  - 17
IP  - 8
DP  - 2012 Aug
TI  - Costs, effects and cost-effectiveness of breast cancer control in Ghana.
PG  - 1031-43
LID - 10.1111/j.1365-3156.2012.03021.x [doi]
AB  - OBJECTIVE: Breast cancer control in Ghana is characterised by low awareness, 
      late-stage treatment and poor survival. In settings with severely constrained 
      health resources, there is a need to spend money wisely. To achieve this and to 
      guide policy makers in their selection of interventions, this study 
      systematically compares costs and effects of breast cancer control interventions 
      in Ghana. METHODS: We used a mathematical model to estimate costs and health 
      effects of breast cancer interventions in Ghana from the healthcare perspective. 
      Analyses were based on the WHO-CHOICE method, with health effects expressed in 
      disability-adjusted life years (DALYs), costs in 2009 US dollars (US$) and 
      cost-effectiveness ratios (CERs) in US$ per DALY averted. Analyses were based on 
      local demographic, epidemiological and economic data, to the extent these data 
      were available. RESULTS: Biennial screening by clinical breast examination (CBE) 
      of women aged 40-69 years, in combination with treatment of all stages, seems the 
      most cost-effective intervention (costing $1299 per DALY averted). The 
      intervention is also economically attractive according to international standards 
      on cost-effectiveness. Mass media awareness raising (MAR) is the second best 
      option (costing $1364 per DALY averted). Mammography screening of women of aged 
      40-69 years (costing $12,908 per DALY averted) cannot be considered 
      cost-effective. CONCLUSIONS: Both CBE screening and MAR seem economically 
      attractive interventions. Given the uncertainty about the effectiveness of these 
      interventions, only their phased introduction, carefully monitored and evaluated, 
      is warranted. Moreover, their implementation is only meaningful if the capacity 
      of basic cancer diagnostic, referral and treatment and possibly palliative 
      services is simultaneously improved.
CI  - (c) 2012 Blackwell Publishing Ltd.
FAU - Zelle, Sten G
AU  - Zelle SG
AD  - Department of Primary and Community Care, Radboud University Nijmegen Medical 
      Center, Nijmegen, the Netherlands. s.zelle@elg.umcn.nl
FAU - Nyarko, Kofi M
AU  - Nyarko KM
FAU - Bosu, William K
AU  - Bosu WK
FAU - Aikins, Moses
AU  - Aikins M
FAU - Niens, Laurens M
AU  - Niens LM
FAU - Lauer, Jeremy A
AU  - Lauer JA
FAU - Sepulveda, Cecilia R
AU  - Sepulveda CR
FAU - Hontelez, Jan A C
AU  - Hontelez JA
FAU - Baltussen, Rob
AU  - Baltussen R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120719
PL  - England
TA  - Trop Med Int Health
JT  - Tropical medicine & international health : TM & IH
JID - 9610576
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Awareness
MH  - Breast Neoplasms/*diagnosis/*economics/therapy
MH  - Costs and Cost Analysis
MH  - Early Detection of Cancer/*economics
MH  - Female
MH  - Ghana/epidemiology
MH  - Health Education/methods
MH  - Humans
MH  - Mammography/economics
MH  - Mass Media
MH  - Middle Aged
MH  - Models, Economic
MH  - Neoplasm Staging
MH  - Palliative Care/economics
MH  - Socioeconomic Factors
EDAT- 2012/07/20 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/07/20 06:00
PHST- 2012/07/20 06:00 [entrez]
PHST- 2012/07/20 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 10.1111/j.1365-3156.2012.03021.x [doi]
PST - ppublish
SO  - Trop Med Int Health. 2012 Aug;17(8):1031-43. doi: 
      10.1111/j.1365-3156.2012.03021.x. Epub 2012 Jul 19.