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Analysis of Mammography Screening Policies under Resource Constraints

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  • Mucahit Cevik
  • Turgay Ayer
  • Oguzhan Alagoz
  • Brian L. Sprague

Abstract

Breast cancer, the leading cause of cancer death for women, can be detected at earlier stages through mammography screening. Therefore, most developed countries implemented population†based mammography screening programs. However, cost of mammography and limited resources in terms of number of trained personnel and diagnostic machines prevent mammography screening to be adopted by many other countries. In fact, even in resource†rich countries, there is a growing concern about cost of mammography screening. In this study, we investigate the optimal allocation of limited mammography resources to screen a population. We propose a constrained partially observable Markov decision process (CPOMDP) model that maximizes total expected quality†adjusted life years of the patients when they are allowed only a limited number of mammography screenings. We use a variable resolution grid†based approximation scheme to convert the CPOMDP model into a mixed†integer linear program and conduct several numerical experiments using breast cancer epidemiology data. We observe that as mammography screening capacity decreases, patients in the 40–49 age group should be given the least priority with respect to screening. We further find that efficient allocation of available resources between patients with different risk levels leads to significant quality†adjusted life year gains, especially for the patients with higher breast cancer risk.

Suggested Citation

  • Mucahit Cevik & Turgay Ayer & Oguzhan Alagoz & Brian L. Sprague, 2018. "Analysis of Mammography Screening Policies under Resource Constraints," Production and Operations Management, Production and Operations Management Society, vol. 27(5), pages 949-972, May.
  • Handle: RePEc:bla:popmgt:v:27:y:2018:i:5:p:949-972
    DOI: 10.1111/poms.12842
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    Cited by:

    1. Robert Kraig Helmeczi & Can Kavaklioglu & Mucahit Cevik & Davood Pirayesh Neghab, 2023. "A multi-objective constrained partially observable Markov decision process model for breast cancer screening," Operational Research, Springer, vol. 23(2), pages 1-42, June.
    2. Ali Hajjar & Oguzhan Alagoz, 2023. "Personalized Disease Screening Decisions Considering a Chronic Condition," Management Science, INFORMS, vol. 69(1), pages 260-282, January.
    3. Malek Ebadi & Raha Akhavan-Tabatabaei, 2021. "Personalized Cotesting Policies for Cervical Cancer Screening: A POMDP Approach," Mathematics, MDPI, vol. 9(6), pages 1-20, March.
    4. Mehmet A. Ergun & Ali Hajjar & Oguzhan Alagoz & Murtuza Rampurwala, 2022. "Optimal breast cancer risk reduction policies tailored to personal risk level," Health Care Management Science, Springer, vol. 25(3), pages 363-388, September.
    5. Sait Tunç & Oguzhan Alagoz & Elizabeth S. Burnside, 2022. "A new perspective on breast cancer diagnostic guidelines to reduce overdiagnosis," Production and Operations Management, Production and Operations Management Society, vol. 31(5), pages 2361-2378, May.

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