Objective  To explore the effectiveness and cost of breast cancer screening strategy that is suitable for the current economic conditions in China.

  Methods  We collected clinical and cost information of breast cancer screening for Chinese women based on previous screening programs conducted from February 2008 to December 2011 and collected the same information about breast cancer cases diagnosed in hospitals at the same time. Markov models were developed to analyze the incremental cost-effectiveness ratios (ICER) for 132 breast cancer screening strategies compared to no screening for Chinese women.

  Results  In 2010, as compared to no screening, the most cost-effective breast cancer screening strategy was biennial screening with clinical breast examination (CBE) and breast ultrasound, in parallel, for women aged between 40 to 64. This screening strategy could save 1, 394 quality-adjusted life years (QALY) per 100, 000 women, and the cost of saving breast-cancer related QALY would be 91, 944 RMB. Sensitivity analysis indicated that in 2016, the most cost-effective breast cancer screening strategy was biennial screening with CBE and mammography (MAM), in parallel, for women aged 40 to 64, with ICER of 159, 637 RMB per QALY.

  Conclusions  Population-based breast cancer screening would be acceptable in the current conditions in China. As the Chinese economy and level of medical care improve, breast cancer screening would be more cost-effective.