Evidence mapPaperPMID 41818282Full record

ArticlePloS one2026

A cost-effective breast cancer screening strategy for Urban China: Findings from a Shenzhen-based modeling study.

Changqing Tu, Yuke Zhong, Huan Li, Haifeng Qi, Qian Lu, Xuesen He

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Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Changqing TuShenzhen Longgang Central Hospital, Shenzhen, China.
Yuke ZhongShenzhen Longgang Central Hospital, Shenzhen, China.
Huan LiShenzhen Maternity and Child Healthcare Hospital, Shenzhen, China.
Haifeng QiShenzhen Maternity and Child Healthcare Hospital, Shenzhen, China.
Qian LuShenzhen Longgang District Center for Disease Control and Prevention, Shenzhen, China.
Xuesen HeShenzhen Longgang Central Hospital, Shenzhen, China.ORCID https://orcid.org/0009-0002-1027-4673

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly detection through breast cancer screening significantly enhances survival rates and reduces mortality. However, financial constraints in low- and middle-income countries often limit the implementation of large-scale screening programs. This study evaluates the cost-effectiveness of a combined Clinical Breast Examination (CBE), Breast Ultrasound (BUS), and supplementary Mammography (MAM), screening strategy for women aged 35-65 in Shenzhen, China. It further identifies optimal screening protocols by analyzing variations in screening frequency, starting/ending ages, and long-term health outcomes.

methodsA Markov model was developed from a societal perspective to assess the lifetime cost-effectiveness of biennial (CBE + BUS)+MAM screening for women aged 35-65. A total of 27 strategies were simulated, varying screening frequency (annual, biennial, triennial), age at initiation (35, 40, 45), age at cessation (65, 69, 70), and modality combinations. Quality-Adjusted Life Years (QALYs) served as the primary health outcome metric. Incremental Cost-Utility Ratios (ICURs) were calculated, with one-way and second-order Monte Carlo sensitivity analyses conducted to evaluate parameter uncertainty.

resultsAmong 699,600 participants, 724 breast cancer cases were detected (detection rate: 103.49 per 100,000), with 88% diagnosed at early stages. The current Shenzhen strategy - biennial Clinical Breast Examination combined with Breast Ultrasound and supplementary Mammography ((CBE + BUS)+MAM/2year/35_65) - demonstrated an ICUR of 140,915 CNY/QALY compared to no screening, below one times the per capita GDP (indicating cost-effectiveness). In various scenarios, while the (CBE + BUS)+MAM/3year/45_65 strategy had a lower ICUR (95,545 CNY/QALY), the ICUR for the current strategy versus this alternative was 518,121 CNY/QALY, still below the willingness-to-pay threshold of 537,000 CNY (three times GDP). Second-order Monte Carlo simulations confirmed the robustness of the current strategy in 76% of scenarios.

conclusionThe (CBE + BUS) +MAM/2year/35_65 strategy was identified as the optimal choice among 27 alternatives, providing a cost-effective balance between early detection and resource efficiency. This evidence solidifies its use and offers a strategic framework for allocating public health resources in Shenzhen and comparable urban settings.

Indexed as

Breast NeoplasmsCost-Benefit AnalysisEarly Detection of CancerMass ScreeningAdultAgedChinaCost-Effectiveness AnalysisFemaleHumansMammographyMarkov ChainsMiddle AgedQuality-Adjusted Life Years

Identifiers

PMID41818282
PMCPMC12981465

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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.