Cancer Causes & Control

, Volume 30, Issue 12, pp 1351–1363 | Cite as

Economics of public health programs for underserved populations: a review of economic analysis of the National Breast and Cervical Cancer Early Detection Program

  • Jaya S. KhushalaniEmail author
  • Justin G. Trogdon
  • Donatus U. Ekwueme
  • K. Robin Yabroff
Original Paper



The purpose of this paper is to provide a brief overview of economic analysis methods used in estimating the costs and benefits of public health programs and systematically review the application of these methods to the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).


Published literature on economic analyses of the NBCCEDP was systematically reviewed. The Consensus on Health Economic Criteria checklist was used to assess methodological quality of the included studies.


Methods available for economic analysis of public health programs include program cost, cost-effectiveness, cost–utility, cost–benefit analysis, and budget impact analysis. Of these, program cost analysis, cost-effectiveness analysis, and cost–utility analysis have been applied to the NBCCEDP in previously published literature.


While there have been multiple program cost analyses, there are relatively fewer cost-effectiveness and cost–utility studies and no cost–benefit and budget impact analysis studies to evaluate the NBCCEDP. Addressing these gaps will inform implementation of effective public health programs with equitable resource allocation to all population subgroups.


Economic analysis Cost-effectiveness Cancer screening Public health Underserved 



The authors sincerely thank Dr. Amy DeGroff, Health Scientist, Division of Cancer Prevention and Control, CDC, for her invaluable suggestions in early version of this manuscript.


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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply  2019

Authors and Affiliations

  1. 1.Division of Cancer Prevention and ControlCenter for Disease Control and PreventionAtlantaUSA
  2. 2.Department of Health Policy and Management, Gillings School of Global Public Health and Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Surveillance and Health Services ResearchAmerican Cancer SocietyAtlantaUSA

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