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Cost-effectiveness of patient navigation for breast cancer screening in the National Breast and Cervical Cancer Early Detection Program



Patient navigation (PN) services have been shown to improve cancer screening in disparate populations. This study estimates the cost-effectiveness of implementing PN services within the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).


We adapted a breast cancer simulation model to estimate a population cohort of women aged 40–64 years from the NBCCEDP through their lifetime. We incorporated their screening frequency and screening and diagnostic costs.


Within the NBCCEDP, Program with PN (vs. No PN) resulted in a greater number of mammograms per woman (4.23 vs. 4.14), lower lifetime mortality from breast cancer (3.53% vs. 3.61%), and fewer missed diagnostic resolution per woman (0.017 vs. 0.025). The estimated incremental cost-effectiveness ratios for a Program with PN was $32,531 per quality-adjusted life-years relative to Program with No PN.


Incorporating PN services within the NBCCEDP may be a cost-effective way of improving adherence to screening and diagnostic resolution for women who have abnormal results from screening mammography. Our study highlights the value of supportive services such as PN in improving the quality of care offered within the NBCCEDP.

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We would like to thank Christen Lara from the Colorado Department of Public Health and the Environment for her assistance in compiling Colorado NBCCEDP cost data for this manuscript.


This research was supported by Contract No. 200-2008-27958 TO 27 from the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

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Correspondence to Benjamin T. Allaire.

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Allaire, B.T., Ekweme, D., Hoerger, T.J. et al. Cost-effectiveness of patient navigation for breast cancer screening in the National Breast and Cervical Cancer Early Detection Program. Cancer Causes Control 30, 923–929 (2019).

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  • Breast cancer
  • Screening
  • Mammography
  • Cost-effectiveness