Developing and testing a cost-assessment tool for cancer screening programs.

BACKGROUND: Cancer screening programs require substantial resources, and economic assessments have become increasingly important in identifying the most cost-effective means of conducting these programs. Such economic assessments require detailed program cost data, but there is no standardized instrument for obtaining these data.
PURPOSE: This study was designed to develop a standardized instrument to collect cost data from cancer screening programs.
METHODS: A cost-assessment tool (CAT) was developed to collect annual cost data based on the findings from case studies at four sites funded by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The data elements collected in the CAT were specifically tailored to collect cost and resource-use information from cancer screening programs. The tool was pilot-tested at nine NBCCEDP sites, and activity-based costs were generated by assigning all cost and resource-use data to specific program activities. Data were collected from November 2004 to February 2005, and the analysis was performed from March to July 2005.
RESULTS: Overall, a majority of the sites (eight of nine) met the acceptable threshold of <5% of total cost remaining unallocated. On average, the largest cost components of the nine programs were screening and diagnostic services (44.4%); recruitment (11.4%); database management (10.9%); and patient support/case management (9.3%).
CONCLUSIONS: Findings from the CAT pilot-testing showed that NBCCEDP cancer screening programs were able to report detailed activity-based cost data. The comparability of these cost data across programs should facilitate pooled analyses that, in turn, may lead to a better understanding of the impact and cost effectiveness of the screening program.