ArticleCancers2024
Evaluating Real World Health System Resource Utilization and Costs for a Risk-Based Breast Cancer Screening Approach in the Canadian PERSPECTIVE Integration and Implementation Project.
Article in Cancers, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Risk Stratified Breast Cancer Screening: Early Outcomes and Psychological Impact from PRSONAL - a Randomized Clinical Trial.Breast (Edinburgh, Scotland) · 2026Trial
- Real-World Evidence for Breast Cancer Risk Stratification: Insights from the P.I.N.K. Study.Cancers · 2026Article
- Article
- Perspectives from a multi-stakeholder workshop for implementing a risk-stratified breast cancer screening program in Canada.Communications medicine · 2026Review
- Over-detection and over-surveillance in breast screening: current status and the potential for artificial intelligence optimisation.Insights into imaging · 2025Review
- Palliative Care With Tracheostomy or Gastrostomy Tube Use and End-of-Life Quality and Costs Among Patients With Head and Neck Cancer.JAMA otolaryngology-- head & neck surgery · 2025Article
- Structural equation modeling of factors influencing women's attitudes, comfort and willingness toward risk-stratified breast cancer screening.Scientific reports · 2025Article
- Stratified/risk-based screening for colorectal cancer in the UK: an overview.Colorectal cancer · 2025Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundA prospective cohort study was undertaken within the PERSPECTIVE I&I project to evaluate healthcare resource utilization and costs associated with breast cancer risk assessment and screening and overall costs stratified by risk level, in Ontario, Canada.
methodsFrom July 2019 to December 2022, 1997 females aged 50 to 70 years consented to risk assessment and received their breast cancer risk level and personalized screening action plan in Ontario. The mean costs for risk-stratified screening-related activities included risk assessment, screening and diagnostic costs. The GETCOST macro from the Institute of Clinical Evaluative Sciences (ICES) assessed the mean overall healthcare system costs.
resultsFor the 1997 participants, 83.3%, 14.4% and 2.3% were estimated to be average, higher than average, and high risk, respectively (median age (IQR): 60 [56-64] years). Stratification into the three risk levels was determined using the validated multifactorial CanRisk prediction tool that includes family history information, a polygenic risk score (PRS), breast density and established lifestyle/hormonal risk factors. The mean number of genetic counseling visits, mammograms and MRIs per individual increased with risk level. High-risk participants incurred the highest overall mean risk-stratified screening-related costs in 2022 CAD (±SD) at CAD 905 (±269) followed by CAD 580 (±192) and CAD 521 (±163) for higher-than-average and average-risk participants, respectively. Among the breast screening-related costs, the greatest cost burden across all risk groups was the risk assessment cost, followed by total diagnostic and screening costs. The mean overall healthcare cost per participant (±SD) was the highest for the average risk participants with CAD 6311 (±19,641), followed by higher than average risk with CAD 5391 (±8325) and high risk with CAD 5169 (±7676).
conclusionAlthough high-risk participants incurred the highest risk-stratified screening-related costs, their costs for overall healthcare utilization costs were similar to other risk levels. Our study underscored the importance of integrating risk stratification as part of the screening pathway to support breast cancer detection at an earlier and more treatable stage, thereby reducing costs and the overall burden on the healthcare system.
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