‘Thousands of deaths prevent breast, intestinal and cervical cancer’ population tests’

The population investigations for breast cancer, colon cancer and cervical cancer prevents thousands of deaths annually and save society a net 60 million euros in future healthcare costs per year. That is the conclusion of one research From the Erasmus MC to the cost -effectiveness of the three population investigations. The saving that results in research into colon cancer is even greater than the total costs of the population screening.

For a hundred thousand people, the population investigations can prevent more than two thousand cases of intestinal and cervical cancer, according to the study. Breast cancer cannot be prevented because it has no detailable precursor. Screening can prevent the number of deaths due to the disease. Added to each other, the three investigations prevent more than 2,500 deaths per 100,000 people. Screening on breast cancer prevents most deaths per hundred thousand women.

Every four years it is calculated how cost -effective the three population investigations are. This time the researchers from the Erasmus MC had extra accurate data. They could consult a data set that keeps track of all the costs that health insurers have reimbursed. “As a result, we were able to map all the care that patients with one of these three types of cancer use, not only the costs of the cancer treatment itself,” says lead researcher Iris Lansdorp-Vogelaar, professor in modeling early detection of cancer at the Erasmus MC.

Lansdorp-Vogelaar: “For example, we were able to take with us how much extra care at the general practitioner or physiotherapist she used in relation to people without those forms of cancer. In this way we carefully determined what the care for these patients costs, and how much healthcare costs saves society.”

Cost -effective

The researchers imitated the entire route that someone with the screening runs. All costs are included, from sending the invitations and the analysis of the results to the costs of follow -up examination and any treatment after an unfavorable test result. That total cost item, around 155 million euros, put the researchers along the yardstick of the price used in the Netherlands for one year of life. For preventive interventions, such as a screening, that limit has recently shifted from 20,000 to 50,000 euros.

“All three screening are cost-effective, they do not exceed that limit of 50,000 euros and therefore do not cost more than we are willing to spend a population screening,” says Lansdorp-Vogelaar. “Screening for colon cancer and a part of cervical cancer (the group that has not had a vaccine against cervical cancer) even yields money. By tracing an early stage of these cancers, more healthcare costs will be saved in the future than testing costs.”

At the bottom of the line is our conclusion for these three studies that the benefits outweigh the disadvantages

False positive

Last April, the Council for Public Health and Society (RVS) came up with an alarming report on the ‘substantial disadvantages’ of early screening and diagnoses in healthcare. RVS chairman Jet Bussemaker advocated in NRC That the advantages of the population investigations for cancer are estimated too high, and the disadvantages too low, partly because in many cases a false positive result comes from such a screening, a false alarm. “That causes fear, stress and uncertainty,” said Bussemaker.

According to Lansdorp-Vogelaar, the research by Erasmus MC does not contradict that conclusion. “The aim of that report was also to make a critical noise. We also think that you should not simply screen for all types of cancer. But at the bottom of the line is our conclusion for these three studies that the benefits outweigh the disadvantages.”

In the study, Lansdorp-Vogelaar also took the unfavorable aspects of screening, such as false positive results and the impact that that can have on people. That loss of quality of life abolished the researchers from the healthy years of life that can yield a screening. For example, they corrected for the negative aspects of a population screening.

“Perhaps the stainless steel has assessed differently than we how to prevent a death of death weighs in relation to an overdiagnosis or an unjustified positive test result,” says Lansdorp-Vogelaar. “Things like that are very difficult to make measurable because it remains subjective.” She does emphasize that the critical report of the RVS makes a distinction between the abundance of testing and screening in the hospital on the one hand, and the three population investigations on the other. “The latter come out more positively.”

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