Table 1 Model Inputs
Variable | Value | Source |
|---|---|---|
Risk prediction | ||
AI (AUC) | 0.71 | [7] |
PRS (AUC) | 0.69 | [6] |
Family history (proportion correctly identified as high risk) | 0.37 | |
Stage distributions | ||
No screening | ||
Local | 0.517 | [17] |
Regional | 0.436 (age < 50); 0.401 (age > =50) | |
Distant | 0.047 (age < 50); 0.082 (age > =50) | |
Biennial screening | ||
Local | 0.650 (age 40–49); 0.690 (age 50–59); 0.742 (age 60–69); 0.758 (age 70–74) | |
Regional | 0.341 (age 40–49); 0.303 (age 50–59); 0.252 (age 60–69); 0.237 (age 70–74) | |
Distant | 0.009 (age 40–49); 0.007 (age 50–59); 0.006 (age 60–69); 0.005 (age 70–74) | |
Annual screening | ||
Local | 0.683 (age 40–49); 0.696 (age 50–59); 0.732 (age 60–69); 0.772 (age 70–74) | |
Regional | 0.310 (age 40–49); 0.297 (age 50–59); 0.262 (age 60–69); 0.223 (age 70–74) | |
Distant | 0.007 (age 40–49); 0.007 (age 50–59); 0.006 (age 60–69); 0.005 (age 70–74) | |
Probabilities | ||
ER positive, HER2 negative | 0.76 | [10] |
ER positive, HER2 positive | 0.1 | |
ER negative, HER2 positive | 0.04 | |
ER negative, HER2 negative | 0.1 | |
Mortality hazard reduction | ||
Tamoxifen | 0.67 | [19] |
Trastuzumab | 0.66 | [19] |
Sensitivity and specificity of mammography | ||
Sensitivity | 0.824 (age 40–49); 0.805 (age 50–59); 0.899 (age 60–69); 0.86 (age 70–74) | [20] |
Specificity | 0.88 (age 40–49); 0.909 (age 50–59); 0.921 (age 60–69); 0.928 (age 70–74) | |
Costs ($) | ||
AI | 112 (28) | [21], Author’s calculation |
OncoArray genetic test | 115 (29) | [22] |
Genetic counseling (per session) | 44 (11) | [23] |
Mammography | 152 (38) | [24] |
Additional diagnostic costs (true positive diagnosis) | ||
Age 40–49 | 2491 (623) | [25] |
Age 50–64 | 2337 (584) | |
Age 65–74 | 2350 (588) | |
Additional diagnostic costs (false positive diagnosis) | ||
Age 40–49 | 261 (65) | [25] |
Age 50–64 | 309 (77) | |
Age 65–74 | 310 (77) | |
Treatment costs | ||
In situ, initial cost | 11,543 (2886); 10,329 (2582) | |
In situ, continuing cost | 0 | |
Localized, initial cost | 29,374 (7343); 18,995 (4749) | |
Localized, continuing cost | 1986 (497); 1267 (317); 1210 (303); 1446 (362); 1044 (261); 817 (204) | |
Localized, terminal cost | 51,800 (12950) | |
Regional, initial cost | 51,859 (12965); 35,365 (8841) | |
Regional, continuing cost | 6747 (1687); 4572 (1143); 4315 (1079); 3744 (936); 2662 (666); 2353 (588) | |
Regional, terminal cost | 58,172 (14543) | |
Distant, initial cost | 56,702 (14176); 43,543 (10886) | |
Distant, continuing cost | 23,581 (5895); 20,945 (5236); 20,162 (5040); 17,744 (4436); 13,094 (3274); 13,478 (3370) | |
Distant, terminal cost | 73,970 (18493) | |
Tamoxifen (5 years) | 1519 (76) | [19] |
Trastuzumab | 81,717 (20429) | [19] |
Utilities | ||
Disutility from screening | 0.006 (0.00003) for 1 week | [25] |
Disutility from additional diagnosis | 0.105 (0.00001) for 5 weeks | |
Health state | ||
Healthy | 0.762–0.859 (depending on age and time since diagnosis) | [14] |
In situ | 0.689–0.777 (depending on age and time since diagnosis) | |
Local | 0.645–0.842 (depending on age and time since diagnosis) | |
Regional | 0.574–0.777 (depending on age and time since diagnosis) | |
Distant | 0.574–0.715 (depending on age and time since diagnosis) | |