Cost-effectiveness assessment of targeted, opportunistic, and population-based skin cancer screening strategies promoted by the Retrate Project of Barretos Cancer Hospital (BCH), Brazil

Background:The melanoma represents a critical public health challenge in Brazil due to increased incidence and the economic and social impact late diagnosis.Early diagnosis is crucial to improve clinical outcomes and minimize associated costs.Given this scenario, the Retrate Project, developed at Barretos Cancer Hospital (BCH), aims to implement innovative screening strategies for skin cancer, with focus on melanoma.Strategies include training primary care health providers, targeted screening in risk groups, the development of teledermatology platform, such as a mobile app and a self-service photo booth.Our study will seek to fill the gaps and prove the effectiveness of skin cancer screening through economic analyzes in health.The cost-effectiveness assessment (ACE) will be done comparing three skin cancer screening strategies: targeted, opportunistic, and population-based.Methods: The study will include participants from the Retrate Project, and will analyze the screening done with a self-service photo booth and mobile app compared to the teletriage carried out by primary care professionals.The analysis will be from the perspective of BCH, which serves 100% through Unified Health System (SUS), and will consider the costs and impacts of screening strategies.The microcosting method will be used to calculate the direct and indirect costs involved, also considering patient adherence and the costs of acquiring technologies and training at 5%.Finally, sensitivity analyses will be performed to assess the variation of the results with a threshold of 20%.This interval will make it possible to evaluate significant variations.Indicating potential increases or decreases in costs for the health system.These sensitivity analyses will play a crucial role in understanding the robustness and financial viability of the proposed approaches, providing valuable data for decisionmaking.Results: The study is expected to identify the most costeffective and feasible screening strategy for the early diagnosis of skin cancer, especially melanoma teledermatology.Results: Preliminary results suggest that the combination of technologies and active search campaigns in risk groups may present the best cost-benefit for the SUS, by reducing treatment costs and improving patient survival.Conclusions: By identifying cost-effective screening strategies, it seeks to optimize resources in the SUS, improve care for oncology patients, and support the development of sustainable public health policies.