Evidence mapPaperPMID 39838341Full record

ArticleBMC public health2025

Comparing the cost-benefit of breast cancer screening programs in rural and urban areas across four economic zones in China: a Markov modeling analysis.

Dachuang Zhou, Kejia Zhou, Wenjuan Wang, Hanqiao Shao, Hongliu Zhang, Wenxi Tang

Abstract readComparative Study
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
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2citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Dachuang ZhouCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Kejia ZhouCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Wenjuan WangCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Hanqiao ShaoCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Hongliu ZhangCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Wenxi TangCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China. tokammy@cpu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study assessed the effectiveness and cost-effectiveness of breast cancer screening across rural and urban regions in China's four economic zones.

methodsUsing a decision-analytic Markov model, we evaluated 5,280 scenarios involving different ages and screening technologies. The model followed individuals from birth through 100 yearly cycles in eight settings. Model parameters, such as incidence, transition rate, attendance and compliance rate, screening accuracy, utility, and mortality, were based on Chinese research and international data. Screening costs were calculated using median medical costs in the respective zones. The main outcome measured was incremental net benefit (INB) and incremental cost-effectiveness ratio (ICER), with sensitivity analyses to assess uncertainty.

resultsUsing a willingness-to-pay threshold of three times the local per capita Gross domestic product (GDP), the recommended strategies varied across regions. However, annual screening of individuals aged 30-70 years with a combination of mammography (MAM) and computed tomography laser mammography (CTL) was the most cost-effective strategy for most regions. The incremental cost-effectiveness ratios (ICERs) of the most cost-effective strategies, compared to no intervention and status quo in China, ranged from US$5,173.31/QALY to US$18,551.27/QALY, and from US$-3,872.28 to US$17,804.59, respectively. Except for the rural central region, where the cost-effective strategy had suboptimal outcomes compared to status quo, the recommended strategies in the other seven regions could prevent 41.12-58.80% and 8.08-35.39% of advanced breast cancer cases, and 18.83-29.27% and 2.71-14.06% of breast cancer deaths, when compared to no screening and status quo, respectively. Sensitivity analysis indicated that the results were robust.

conclusionOur study identified cost-effective breast cancer screening strategies suitable for the rural and urban areas in China's four major economic zones. These findings highlight the necessity of universal screening and the importance of optimizing strategies based on regional economic development and epidemiological characteristics. These insights are crucial for improving national breast cancer screening policies.

Indexed as

Breast NeoplasmsEarly Detection of CancerMass ScreeningUrban PopulationAdultAgedChinaCost-Benefit AnalysisFemaleHumansMammographyMarkov ChainsMiddle AgedRural PopulationBreast cancerChinaCost-effectivenessHealth economicsQuality-adjusted life years

Identifiers

PMID39838341
PMCPMC11753165

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.