OBJECTIVES: Early cancer screening may enhance health outcomes and reduce patient burden and cancer treatment costs. The value of cancer screenings has been assessed extensively. This research aimed to assess the methods employed in economic models of cancer screening tests.

METHODS: An SLR was conducted using PICOS (Population, Intervention, Comparators, Outcomes, Study Design) criteria. Embase, Medline, Econlit, and Cochrane were searched in addition to gray literature for eligible studies. US economic models assessing the additional value/costs of cancer screening tests to standard of care or no screening published between 2008-2023 in English were included.

RESULTS: 73 studies were included (colorectal: n=35; breast: n=13; lung: n=8; multi-cancer early detection: n=6; gastric: n=5; cervical: n=2; head and neck: n=2; esophageal: n=1; prostate cancers: n=1). Most studies were cost-effectiveness/cost utility analyses (n=66), with few cost benefit analyses (n=4) and cost impact studies (n=3). Model types were commonly simulation models (n=45) or Markov models (n=22), analyzed from a payer (n=34), healthcare system (n=15), or societal perspective (n=14). 35 studies used a lifetime horizon, other studies employed shorter time horizons, e.g., 15 years. Indirect costs, such as patients’ productivity, travel time and costs, were included in only 6 studies, with caregiver impacts rarely considered (n=2). Modeling cohorts included populations with cancer risk factors, such as age, family history, dense breasts, smoking history, alcohol consumption, and minority race/ethnicity groups.

CONCLUSIONS: Value assessments of cancer screenings concentrate on USPSTF-recommended screenings. Assessments potentially underestimate the full value/impacts on society by only considering direct costs, limited indirect cost components, and/or by truncating the assessments to a short time horizon. Decision-makers should take into account these considerations when allocating resources for cancer preventive care.