Table 1 Input parameters for economic evaluation of the prevention of breast cancer through the promotion of breastfeeding in Hong Kong
From: Potential cost-savings of breastfeeding promotion to prevent breast cancer: a Monte Carlo simulation
Input parameter | Point estimate | Uncertainty range | Distribution | Source of data and Remarks |
|---|---|---|---|---|
Age-specific fertility rates of 20-49-year-old females in 2018 | NA | NA | NA | Hong Kong Census and Statistics Department |
All-cause age-specific mortality rates in 2018 | NA | NA | NA | Hong Kong Census and Statistics Department |
Age-specific female invasive breast cancer incidence rate in 2018 | NA | NA | NA | Hong Kong Cancer Registry, Hospital Authority [1] (Supplementary Table S1) |
Female invasive breast cancer stage distribution in 2018 | ||||
I | 0.62 | - | Dirichlet | Hong Kong Cancer Registry, Hospital Authority [1] |
II | 0.16 | |||
III | 0.13 | |||
IV | 0.09 | |||
Aggregated medical treatment costs (per case, $US 2017 level) | ||||
Stage I | $27,683 | ($20,762-$34,604) | Uniform | Leung et al., 2021 [11] |
Stage II | $31,831 | ($23,873-$39,789) | ||
Stage III | $38,374 | ($28,781-$47,968) | ||
Stage IV | $83,217 | ($62,413-$104,021) | ||
Terminal Care | $27,208 | ($20,271-$33,785) | ||
5-year survival probability for female invasive breast cancer Stages 1–4 | ||||
Stage I | 0.993 | NA | NA | Hong Kong Cancer Registry, Hospital Authority [1] (Supplementary Table S2) |
Stage II | 0.946 | |||
Stage III | 0.762 | |||
Stage IV | 0.298 | |||
Disability weight | ||||
Diagnosis and primary therapy phase | 0.288 | (0.193, 0.399) | Triangular | Global Burden of Disease study 2017 [12] |
Controlled phase | 0.049 | (0.031, 0.072) | ||
Metastatic phase | 0.451 | (0.307, 0.600) | ||
*Relative risk of breast cancer by duration of any breastfeeding (for Scenario 1) | ||||
Never | 1 | - | Triangular | Unar-Munguía 2017 [13] |
1–2 months | 0.9 | (0.86, 0.93) | ||
3–5 months | 0.85 | (0.82, 0.89) | ||
6–8 months | 0.86 | (0.82, 0.91) | ||
9–11 months | 0.87 | (0.82, 0.91) | ||
12–23 months | 0.86 | (0.82, 0.9) | ||
24–35 months | 0.81 | (0.76, 0.85) | ||
*Relative risk of breast cancer in flavour of exclusive breastfeeding for 6 months (for Scenario 2) | ||||
No | 1 | - | Triangular | Unar-Munguía 2017 [13] |
Yes | 0.72 | (0.58, 0.90) | ||
Duration of any (exclusive/partial) breastfeeding in a woman’s lifetime (base case or scenario 1) | ||||
Months | 76.6% | (74.8%, 78.4%) | Triangular | Breastfeeding survey 2018, Department of Health [8] (Supplementary Table S3) |
At 2 months | 66.4% | (64.4%, 68.4%) | ||
At 4 months | 55.7% | (53.6%, 57.5%) | ||
At 6 months | 46.5% | (44.4%, 48.6%) | ||
At 12 months | 26.1% | (24.3%, 27.9%) | ||
Proportion of 6-month-old infants exclusive breastfed in Hong Kong in 2018 (Base case for scenario 2) | 26% | (24.50%, 28.10%) | Triangular | Breastfeeding survey 2018, Department of Health [8] |