ECONOMIC BURDEN AND BARRIERS ASSOCIATED WITH EARLY DIAGNOSIS OF BREAST CANCER IN THE UNITED STATES: A SYSTEMATIC LITERATURE REVIEW (SLR)
Author(s)
Ashish Pandey, M. Pharm1, Geetika Kainthla, MSc.2, Rashi Tomer, M. Pharm1, Sayyeda Anam, M. Pharm1, Upasna Gaba, M. Pharm2, Sahil Sharma, M. Pharm2, Rajpal Singh, Ph.D.2, George Agathangelou, BA3, Scott B Robinson, MA, MPH4.
1ZS Associates, Noida, India, 2ZS Associates, Gurugram, India, 3ZS Associates, London, United Kingdom, 4ZS Associates, Durham, NC, USA.
1ZS Associates, Noida, India, 2ZS Associates, Gurugram, India, 3ZS Associates, London, United Kingdom, 4ZS Associates, Durham, NC, USA.
OBJECTIVES: Early diagnosis of breast cancer is associated with improved survival and reduced treatment costs; however multiple barriers continue to delay early detection, particularly in underserved populations. This SLR aimed to evaluate the economic impact of early breast cancer diagnosis in the USA and to identify key economic and health-care related barriers associated with early detection.
METHODS: An SLR was conducted in accordance with Cochrane guidelines using Embase and MEDLINE to identify USA based studies published between 2020 and 2025. Eligible studies evaluated economic burden of breast cancer and/or barriers to early screening among adult women (≥18 years) with or at risk of breast cancer.
RESULTS: Five studies met the inclusion criteria, including one claims-based study evaluating economic burden and four studies examining barriers to early breast cancer screening. The findings from economic burden study demonstrated that stage at diagnosis was a key driver of healthcare costs. Medical expenditures increased progressively with advancing disease stage, incremental costs rose by stage beyond 6 months, reaching $7,346, $11,859, $21,501, and $20,235 for in situ, localized, regional, and distant disease, increasing to $9,728, $17,056, $38,840, and $44,409 at 24 months respectively. Total costs, including hospitalization, physician services, outpatient care, drug costs, and other medical expenses were higher with advancing stage and with delays in diagnosis. Additional four studies reported economic and access-related barriers to early diagnosis, including out-of-pocket costs, financial stress, competing basic needs, income-related disparities, limited access to screening services, and challenges among uninsured or low-income populations.
CONCLUSIONS: This review demonstrates that breast cancer prognosis and costs worsen with more advanced stage at diagnosis. Persistent economic and access barriers contribute to delayed detection and avoidable healthcare expenditures. Given limited recent USA data, further research is needed to better inform screening and policy decisions.
METHODS: An SLR was conducted in accordance with Cochrane guidelines using Embase and MEDLINE to identify USA based studies published between 2020 and 2025. Eligible studies evaluated economic burden of breast cancer and/or barriers to early screening among adult women (≥18 years) with or at risk of breast cancer.
RESULTS: Five studies met the inclusion criteria, including one claims-based study evaluating economic burden and four studies examining barriers to early breast cancer screening. The findings from economic burden study demonstrated that stage at diagnosis was a key driver of healthcare costs. Medical expenditures increased progressively with advancing disease stage, incremental costs rose by stage beyond 6 months, reaching $7,346, $11,859, $21,501, and $20,235 for in situ, localized, regional, and distant disease, increasing to $9,728, $17,056, $38,840, and $44,409 at 24 months respectively. Total costs, including hospitalization, physician services, outpatient care, drug costs, and other medical expenses were higher with advancing stage and with delays in diagnosis. Additional four studies reported economic and access-related barriers to early diagnosis, including out-of-pocket costs, financial stress, competing basic needs, income-related disparities, limited access to screening services, and challenges among uninsured or low-income populations.
CONCLUSIONS: This review demonstrates that breast cancer prognosis and costs worsen with more advanced stage at diagnosis. Persistent economic and access barriers contribute to delayed detection and avoidable healthcare expenditures. Given limited recent USA data, further research is needed to better inform screening and policy decisions.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE478
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology