Early cancer diagnosis saves lives, Canada's healthcare system millions, research shows

Researchers at the University of Ottawa (uOttawa) say while recent research shows breast cancer cases are on the rise among younger Canadians, early diagnosis not only saves lives, but also saves the country's healthcare system nearly $500 million.

Early detection of breast cancer can spare patients chemotherapy and radiotherapy, said the university in a news release on Thursday.

“When breast cancers are detected at an early stage, less intensive treatments can be employed such as lumpectomies instead of mastectomies, single (sentinel) node biopsies instead of removing all the lymph nodes in the armpit, and often omitting chemotherapy and radiotherapy," said Lead author Dr. Anna Wilkinson, an associate professor in the Faculty of Medicine at the uOttawa and a GP oncologist at The Ottawa Hospital (TOH) Cancer Centre in the release.

“Breast cancer survival is predicated by stage at diagnosis: The five-year net survival for Stage I breast cancer is 100 percent which, subsequently, declines to 92 per cent, 74 per cent and 23 per cent with stage II, III and IV breast cancers.”

While the university was advocating to adopt the screening model used in the United States for women in their 40s, it found the current "cost effectiveness analyses are outdated and do not reflect expensive new advances that have become standard of care.”

Dr. Wilkinson says though the new advanced technologies offer innovative ways to treat cancer after diagnosis, the costs can rise rapidly depending on the stage, noting that earlier stages could be cheaper to tackle. She adds that traditional costing models depend on the data that reflects the number of patients diagnosed, noting that the university's calculations are more comprehensive, as they include the costs of diagnosis, pathology, radiology, surgery, radiation oncology, hospital stay, pharmacy, nursing and palliative care.

"For example, new targeted therapies for high-risk stage II and III hormone sensitive breast cancers can cost nearly $142K over two years and over $210K for three years in the metastatic setting. A highly effective antibody drug conjugate for HER2 positive and HER2 low breast has a cost of $166K for one year of therapy and immunotherapy for triple negative breast cancer is $153K for one year of therapy. Stage IV costs for certain subtypes can rise past $500,000," Dr. Wilkinson said.

According to the uOttawa's calculations, screening women starting at age 40 rather than 49, which is the current starting time in Canada saves the Canadian healthcare system $459.6 million dollars, averts 3,499 breast cancer deaths. It also results in "52,367 life years gained," which "translates into a savings of $1,880 for every women screened," says Dr. Wilkinson.

"We should see this study as a call for similar analyses of the cost effectiveness of early screening for colon, lung and cervical cancers. Evidence of costs savings with cancer screening could target the health inequities created by different cancer screening practices across Canada," Dr. Wilkinson added.

The calculations and suggested findings about costs will be presented at the ESMO Breast Cancer Annual Congress. Wilkinson and a team of uOttawa and Ottawa Hospital researchers collaborated with Sunnybrook Research Institute to examine the cost-effectiveness of breast cancer treatments.