Biennial screening mammography is cost effective in healthy women aged over 65 years

Question. What is the cost-effectiveness of screening mammography in women over 65 years old? Study design. Systematic review with narrative synthesis. Main results. Ten studies, out of 115 identified, met inclusion criteria. Studies had similar cost-effectiveness findings; extending biennial screening to ages 75-80 years cost, on average, $34,000-$88,000 per life year gained compared with stopping screening at age 65 (adjusted to 2002 US dollars). Two studies found breast cancer screening less effective at reducing mortality in women with significant comorbidities (dementia, congestive heart failure, or hypertension), thus reducing the cost-effectiveness of screening in this population. No study fully adjusted for potential harms of screening. Authors' conclusions. In women aged over 65 years without serious comorbidity, biennial breast cancer screening reduces mortality at reasonable costs.