Targeted Screening Interventions for Breast Cancer: Impact on Economic and Health Outcomes in Disadvantaged Populations

OBJECTIVES: Breast cancer, the leading cancer among French women, incurs high treatment costs^1,2. Early detection through organized screening reduces these costs and improves survival rates³. However, social disparities in screening participation lead to delayed diagnoses and increased expenditures⁴. This study evaluates the budgetary impact of lower screening rates among disadvantaged populations in Nice, France, compared to more advantaged ones. It also evaluates how targeted local measures could affect the costs and outcomes of breast cancer.

METHODS: An agent-based model will simulate behaviours and care pathways of breast cancer patients in Nice. Demographic and socio-economic data gathered from several sources at the Merged Islets for Statistical Information (IRIS) scale will be used to create a virtual cohort representing the target population. Screening rates will be calculated for two scenarios: a baseline with current non-participation rates and an optimized scenario with adjusted rates to maximize socio-economic favourability. Care trajectories and costs, including direct medical and non-medical expenses and work absences, will be modeled using national claims data.

RESULTS: Initial analysis over two years showed a positive correlation between the local human development index and organized screening⁵. Access to public transport increased participation, while managerial status was linked to lower screening rates. Single working women had a higher risk of non-participation. Screening rates were below expectations in 16 IRISs, indicating significant disparities. Disadvantaged populations are expected to screen less frequently, leading to later diagnoses and higher treatment costs. The model will incorporate these findings to assess budgetary impacts and measure the potential of targeted actions to reduce screening disparities and costs.

CONCLUSIONS: The initial results of this study confirm significant social disparities in breast cancer screening rates. Evaluating their effects on costs and outcomes, and the efficiency of targeted interventions in disadvantaged areas, is essential for reducing health inequalities and healthcare expenses.