Cancer Screening Costs in Catalonia: A Comparative Study Between the Three Screening Programs

OBJECTIVES: Well-established population-based screening programs for breast, colorectal, and cervical cancers have proven effective in reducing cancer incidence or mortality. Assessing the economic burden of these is essential for identifying potential enhancements that can minimize costs and reinforce sustainability within healthcare systems. This study aimed to estimate the direct medical costs of the three cancer screening programs in Catalonia and detect potential areas for improvement to optimize current and future programs.

METHODS: Micro and macro data collected from various official sources were used to estimate health expenses associated with infrastructure, organization, and screening and diagnostic procedures for the three programs from a Health System perspective. The total annual costs of the screening process were calculated based on the established screening circuits for breast and colorectal cancers, as well as ongoing pilot studies involving the use of self-sampling for cervical cancer. Additionally, the annual costs per invited and screened person were estimated.

RESULTS: During the evaluation of the three programs, several main cost categories were identified and compared: 1) Programmatic and management costs, 2) Screening and triage testing costs, and 3) Infrastructure costs. The cost per person screened was highest for cervical cancer screening, followed by breast and colorectal cancer screening. The analysis highlighted key areas with significant economic impacts across the screening programs.

CONCLUSIONS: Understanding the costs associated with each population screening program, as well as identifying those aspects of the screening process that have the greatest impact on costs, provides opportunities for optimizing program design. These insights are crucial for guiding decision-making in the implementation, modification, and sustainability of the programs.