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Utilization and cost of diagnostic imaging and biopsies following positive screening mammography in the southern breast cancer screening region of the Netherlands, 2000–2005

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Abstract

We prospectively assessed trends in utilization and costs of diagnostic services of screen-positive women in a biennial breast cancer screening program for women aged 50–75 years. All 2,062 women with suspicious findings at screening mammography in the southern region of the Netherlands between 1 January 2000 and 1 July 2005 (158,997 screens) were included. Data were collected on any diagnostic examinations, interventional procedures, and surgical consultations with two-year follow-up. We used national reimbursement rates to estimate imaging costs and percutaneous biopsy costs. Cost prices, charged by hospitals, were used to estimate open surgical biopsy costs and surgical consultation costs. The largest increase in utilization of diagnostic procedures per 100 referrals was observed for axillary ultrasound (from 3.9 in 2000 to 33.5 in 2005) and for stereotactic core biopsy (from 2.1 in 2000 to 26.8 in 2005). Per 100 referrals, the open surgical biopsy rate decreased from 34.7 (2000) to 4.6 (2005) and the number of outpatient surgical consultations fluctuated between 269.8 (2000) and 309.7 (2004). Mean costs for the diagnosis of one cancer were €1,501 and ranged from €1,223 (2002) to €1,647 (2003). Surgical biopsies comprised 54.1% of total diagnostic costs for women screened in 2000, but decreased to 9.9% for women screened in 2005. Imaging costs increased from 23.7 to 43.8%, percutaneous biopsy costs from 9.9 to 27.2%, and consultation costs from 12.3 to 19.1%. We conclude that diagnostic costs per screen-detected cancer remained fairly stable through the years, although huge changes in the use of different diagnostic procedures were observed.

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Authors and Affiliations

  1. Department of Radiology, Catharina Hospital, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands

    Lucien E. M. Duijm

  2. Centre of Expertise Transitions in Care, Hogeschool Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, The Netherlands

    Johanna H. Groenewoud

  3. Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands

    Jacques Fracheboud & Harry J. de Koning

  4. Department of Radiology, Máxima Medical Center, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands

    Menno L. Plaisier

  5. Department of Surgery, Máxima Medical Center, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands

    Rudi M. H. Roumen

  6. Institute of Health Policy and Management, Erasmus Medical Center, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands

    B. Martin van Ineveld

  7. Regional Laboratory for Pathology, PAMM laboratories, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands

    Mike van Beek

Authors
  1. Lucien E. M. Duijm
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  2. Johanna H. Groenewoud
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  3. Jacques Fracheboud
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  4. Menno L. Plaisier
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  5. Rudi M. H. Roumen
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  6. B. Martin van Ineveld
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  7. Mike van Beek
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  8. Harry J. de Koning
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Correspondence to Lucien E. M. Duijm.

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Duijm, L.E.M., Groenewoud, J.H., Fracheboud, J. et al. Utilization and cost of diagnostic imaging and biopsies following positive screening mammography in the southern breast cancer screening region of the Netherlands, 2000–2005. Eur Radiol 18, 2390–2397 (2008). https://doi.org/10.1007/s00330-008-1043-5

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  • DOI: https://doi.org/10.1007/s00330-008-1043-5

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