Melanoma screening of people over 50 years old is as cost-effective as other nationally recommended cancer screening programs, according to an article in the January issue of Archives of Dermatology.
Melanoma care costs more than $740 million each year in the United States, with older patients at the highest risk. Melanoma screening is becoming popular due to increased knowledge of risk factors and availability of treatment.
Elena Losina, Ph.D., Boston University School of Public Health, and colleagues designed a mathematical model to simulate melanoma events that occur in a population, including disease occurrence, progression, detection with and without a screening program, treatment and death. The authors assessed the additional screening costs and the survival attributable to earlier detection. Four screening strategies were considered: background screening only (skin examination at a routine non-dermatologist physician visit) and referral to dermatologist once every five years; one-time, every two years and annual screening by a dermatologist in adults over 50.
They used a measure of cost-effectiveness to determine the relative value of different screening procedures. The lower the cost, the more cost-effective (that is, the less cost of the procedure per extra year of life), the more justification for wide adoption of the procedure. The authors found the cost of one-time screening was about $10,100 per quality-adjusted life year gained compared with current practice. Costs totaled $80,700 per quality-adjusted life year gained for screening every two years compared with one-time screening, and $586,800 per quality-adjusted life year gained for annual screening compared with screening every two years.
Among siblings of patients with melanoma, one-time screening cost $4,000 per quality-adjusted life year gained compared with an additional $35,500 for screening done every two years and an additional $257,800 per quality-adjusted life year for annual screening.
Because, as the authors write, “…interventions in the United States are generally considered cost-effective at less than $50,000 per quality-adjusted life year gained or less than $100,000 per quality-adjusted life year gained,” they concluded that the one-time screening of U.S. adults at 50 years old for malignant melanoma is cost-effective and screening every two years of siblings of patients with melanoma may also be cost-effective.
About the Author
Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.
The author has no financial relationship to any of the companies listed in the article.
From the NetDoc medical news feed