How Effective is Population-Based Cancer Screening? Regression Discontinuity Estimates from the US Guideline Screening Initiation Ages

Kadiyala Srikanth and Erin Strumpf
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Kadiyala Srikanth: RAND Corporation, Santa Monica, CA, USA

Forum for Health Economics & Policy, 2016, vol. 19, issue 1, 87-139

Abstract: We estimate the marginal benefits of population-based cancer screening by comparing cancer test and detection rates on either side of US guideline-recommended initiation ages (age 40 for breast cancer and age 50 for colorectal cancer during the study period). Using a regression discontinuity design and self-reported test data from national health surveys, we find test rates for breast and colorectal cancer increase at the guideline age thresholds by 109% and 78%, respectively. Data from cancer registries in twelve US states indicate that cancer detection rates increase at the same thresholds by 50% and 49%, respectively. We estimate significant effects of screening on earlier breast cancer detection (1.2 cases/1000 screened) at age 40 and colorectal cancer detection (1.1 cases/1000 individuals screened) at age 50. Forty-eight and 73% of the increases in breast and colorectal case detection occur among middle-stage cancers (localized and regional) with most of the remainder among early-stage (in-situ). Our analysis suggests that the cost of detecting an asymptomatic case of breast cancer at age 40 via population-based screening is $107,000–134,000 and that the cost of detecting an asymptomatic case of colorectal cancer at age 50 is $473,000–485,000.

Keywords: cancer detection; cancer screening; regression discontinuity design (search for similar items in EconPapers)
JEL-codes: I10 I12 I18 (search for similar items in EconPapers)
Date: 2016
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Citations: View citations in EconPapers (6)

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DOI: 10.1515/fhep-2014-0014

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