Published in PLOS One on 2026-06-12, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original study title: Cost-effectiveness analysis of mammography screening for early detection of breast cancer in Nigeria
Original authors: Ifeoma Jovita Nduka, Charles Ebuka Okafor, Obinna Ikechukwu Ekwunife
Source: PLOS One • DOI 10.1371/journal.pone.0351492
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Mammography still remains the gold standard for breast cancer screening, considering its impact on breast cancer mortality. However, it has a relatively low utilization rate in Nigeria. Although the National Strategic Cancer Control Plan (NSCCP) has a goal of making screening services and early detection of cancer available for all Nigerians, there is currently no national breast cancer screening program implemented in Nigeria. The modelling study aimed to evaluate the cost-effectiveness of mammography screening from the healthcare provider’s perspective and to determine the appropriate screening interval for Nigerian women, aiming to enhance the efficiency and effectiveness of breast cancer detection programs. A state-transition Markov model was adapted to simulate annual and biennial mammography, breast cancer diagnosis, and treatment in a cohort of cancer-free Nigerian women aged 40 years and followed them for a lifetime. The study was conducted from the healthcare provider’s perspective. Disability-adjusted life year (DALY) averted, representing the health outcomes, was used to estimate the incremental cost-effectiveness ratio (ICER). Costs and outcomes were discounted at an annual rate of 5%. Annual mammography screening costs US$238.60, averted a DALY of 1.060, and was the most cost-effective intervention with an ICER of US$207.24 (95% CI US$213.31 – US$216.88)/DALY averted, which was below the willingness-to-pay threshold of $1074. Mammography screening strategies were estimated to be cost-effective from the healthcare payer’s perspective under the model assumptions. Annual screening showed the most favorable cost-effectiveness profile among the strategies evaluated, but this finding is model-dependent and should be interpreted as comparative economic evidence rather than a definitive screening recommendation. These results can inform future research, policy discussions, and consideration of sustainable financing for breast cancer screening in Nigeria.
Introduction
With a global estimate of 2.3 million new cases (23.8%), female breast cancer is the most commonly diagnosed cancer [1], accounting for 15.4% of cancer deaths with considerably higher death rates in low- and middle-income countries (LMICs) [1,2]. In Nigeria, breast cancer remains the most prevalent cancer, accounting for 40.5% of new cancer cases, and the leading cause of cancer-related death (35.0%) [2].
Mammography is considered the gold standard for breast cancer screening due to its proven ability in the timely detection of breast cancer in asymptomatic individuals and reduction in breast cancer-related deaths by 15–56% [3–5]. However, its effectiveness is dependent on the adherence rate. As such adherence to routine mammography screening is crucial [5,6]. As early diagnosis of breast cancer coupled with comprehensive treatment results in improved prognosis of the disease and a reduction in mortality rate, its need cannot be overemphasized [7]. In Nigeria, early diagnosis of breast cancer encounters numerous challenges resulting in late presentation. These challenges range from poor symptom recognition, inadequate knowledge, poor healthcare system, financial constraints, fear of diagnosis, and reliance on traditional medicine [8,9].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Ifeoma Jovita Nduka, Charles Ebuka Okafor, Obinna Ikechukwu Ekwunife. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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