Table 3.

Cost-effectiveness of Cancer Screening Programs and US Preventive Services Task Force Ratings

Screening Program	Description	Cost-effectiveness Ratio, $*	Source	USPSTF Rating†
Breast cancer	Mammogram every 2 years, ages 50–69 y	30 500/QALY	25	B
Cervical cancer	Papanicolaou test every year, lifetime	24 100/QALY	26	A
Colorectal cancer	Fecal occult blood test plus sigmoidoscopy every 5 years after age 50 y	47 400/YLS	27	A
Melanoma
Siblings of patients with melanoma	Visual screening every 2 years after age 50 y	35 500/QALY	Current study	I
General population	Visual screening 1 time, at age 50 y	10 100/QALY	Current study	I
Prostate cancer	Combined digital rectal examination and prostate-specific antigen determination 1 time, age 50–59 y	20 400/YLS	28	I

Abbreviations: QALY, quality-adjusted life year; USPSTF, US Preventive Services Task Force; YLS, year of life saved.

^*All costs are reported in 2004 US dollars.

^†USPSTF ratings²⁸: A indicates the USPSTF strongly recommends that clinicians provide [the service] to eligible patients. The USPSTF found good evidence that [the service] improves important health outcomes and concludes that benefits substantially outweigh harm. B indicates the USPSTF recommends that clinicians provide [the service] to eligible patients. The USPSTF found at least fair evidence that [the service] improves important health outcomes and concludes that benefits outweigh harm. I indicates the USPSTF concludes that the evidence is insufficient to recommend for or against routinely providing [the service]. Evidence that [the service] is effective is lacking, of poor quality, or conflicting and the balance of benefits and harm cannot be determined.