Data used to estimate QALYs for mammographic breast cancer screening of women aged 50, by scenario
| Parameter and scenario | Value | Sources |
|---|---|---|
| Relative risk reduction in mortality from breast cancer: | ||
| Scenario 1 | −30% for 10 years, 0% thereafter | Forrest report1 |
| Scenarios 2-3 | −19% | Gøtzsche and Nielsen Cochrane review6 |
| Scenario 4 | −15% | Gøtzsche and Nielsen Cochrane Review6 |
| Scenario 5 | −14% at age 50-9 over 10 years, −32% at age 60-9 over 10 years | Nelson et al, US systematic review7 8 |
| False positive rate: | ||
| All scenarios | 6.39% at 1st invitation; 3.06% at 2nd and subsequent invitation | Smith-Bindman et al14 |
| Loss of quality of life | −5% | Best estimates based on Peasgood,15 Stout,16 De Haes,17 Madan18 |
| Duration of loss (years) | 0.2 | |
| Breast cancer surgery: | ||
| Relative risk | 35% (26% to 44%) | Gøtzsche and Nielsen Cochrane review6 |
| Loss of quality of life: | ||
| Scenarios 1-2 | −6% for lives saved only | Forrest report1 |
| Scenarios 3, 4, 5 | −6% for all who had surgery | Peasgood,15 Stout,16 De Haes17 |
| Sensitivity analysis | ±2% | COMICE trial13 |
| Duration of loss | Permanent in base case6 | Forrest report,1 Peasgood,15 Stout,16 De Haes,17 PRIME trial follow-up14 |
| Sensitivity analyses | 5 and 10 years’ duration | |
| Baseline mortality from breast cancer | Rates per 100 000: 73.65 at age 50-54, 97.55 at age 55-59, 117.47 at age 60-64, 123.03 at age 65-69 | NHS mortality statistics for 1985, England9 |
| Baseline risk of breast cancer surgery | Rate per 100 000: 438.01 aged 45-64 | HIPE for England 198510 11 |
| Screening attendance rate | 73.2% | Advisory Committee on Breast Cancer Screening19 |
| Time frame | 0-20 years, scenarios (except scenarios with 5 and 10 year duration) | — |
QALY=quality adjusted life year.