Economic evaluations of screening programs: A review of methods and results

Background: The economics of screening is part of the broader area of the economics of prevention, and is concerned with the allocation of resources to screening activities when confronted with the problem of scarcity. Issues: One important aspect of the economics of screening is the economic evaluation of screening programs. Economic evaluation involves a systematic assessment of the costs and benefits of screening. Results: A review of methods and results of economic evaluations of screening produces no generalizable conclusion about the economic desirability or otherwise, of screening programs. Each particular screening program must be evaluated on its merits. There is no evidence of any systematic tendency for screening programs to be more or less cost-effective than other prevention or treatment programs. Across all programs, substantial disparities have been found in cost-effectiveness. Conclusions: The challenge in the future will be to secure the re-allocations of resources necessary to maximize health gains from limited health care resources, rather than to undertake the analyses on which such re-allocations would be based.