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Outcomes included 5-year relative survival, deaths prevented at 5 years, cost per death prevented, and total costs. RESULTS. The findings suggest that the total cost of breast cancer is 3.6 times higher with the screening mammography program but results in a 27.9% reduction in breast cancer deaths over the first 5 years of the program. Both costs and deaths prevented are sensitive to the incidence of breast cancer in the population and are less favorable in the range of incidence seen in American Indians. CONCLUSIONS. The cost and impact of a given strategy for cancer screening vary among communities with different disease incidence, stage at diagnosis, and stage-specific survival, as seen in American Indian populations. <\/jats:p>","DOI":"10.2105\/ajph.84.10.1631","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T13:18:52Z","timestamp":1227964732000},"page":"1631-1636","source":"Crossref","is-referenced-by-count":22,"title":["The danger of applying uniform clinical policies across populations: the case of breast cancer in American Indians."],"prefix":"10.2105","volume":"84","author":[{"given":"P A","family":"Nutting","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B N","family":"Calonge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D C","family":"Iverson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L A","family":"Green","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"p_1","unstructured":"Institute of Medicine. 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