Cost-effectiveness of using artificial intelligence versus polygenic risk score to guide breast cancer screening

BMC Cancer

Table 4 Alternative RR thresholds

Strategy	Cost (in 1000 $)	Effectiveness (in QALYs)	ICER ($/QALY)
*Panel A: RR threshold 1.3*
No screening	1,745,808	1,976,720	–
Family history + no screening for low risk	1,823,664	1,978,241	Ext. dominated
AI + no screening for low risk	1,845,197	1,980,697	24,994
PRS + no screening for low risk	1,861,378	1,980,799	157,870
Family history + biennial screening for low risk	1,879,254	1,980,731	Dominated
PRS + biennial screening for low risk	1,921,493	1,978,380	Dominated
AI + biennial screening for low risk	1,936,713	1,978,375	Dominated
Annual screening for all	2,022,120	1,978,717	Dominated
*Panel B: RR threshold 2*
No screening	1,745,808	1,976,720	–
AI + no screening for low risk	1,813,821	1,980,868	16,398
Family history + no screening for low risk	1,823,664	1,978,241	Dominated
PRS + no screening for low risk	1,830,198	1,980,922	299,464
Family history + biennial screening for low risk	1,879,254	1,980,731	Dominated
AI + biennial screening for low risk	1,906,031	1,979,063	Dominated
PRS + biennial screening for low risk	1,914,734	1,978,709	Dominated
Annual screening for all	2,022,120	1,978,717	Dominated

Note: ICER: Incremental Cost-Effectiveness Ratio. All costs are in 2020 US dollars ($). Costs and effectiveness are calculated per 100,000 women. All strategies (except ‘No screening’) involve annual screening for women identified as high-risk. ‘AI’ refers to risk prediction accounting for both AI and other risk factors. ‘PRS’ refers to risk prediction accounting for both PRS and other risk factors. Beyond age 50, women without family history are screened biennially and those with family history are screened annually in all strategies except ‘No screening’ and ‘Annual screening for all’ strategies. In Panel A, ‘Family history + no screening for low risk’ is extended dominated. Hence, ICER for ‘AI + no screening for low risk’ is calculated relative to ‘No screening’

ISSN: 1471-2407