ECONOMIC-EVALUATION OF SCREENING FOR PROSTATE-CANCER - A RANDOMIZED POPULATION-BASED PROGRAM DURING A 10-YEAR PERIOD IN SWEDEN

Prostate cancer is a growing health problem representing considerable costs. Screening and early curative treatment may reduce morbidity and possibly prevent future escalating costs. However, population screeni ng programmes are generally not well accepted at present due to uncera inty about whether screening for prostate cancer can result in reduced mortality. Evidence from large, randomized, controlled trials is stil l lacking. The objective of this study was to calculate clinical and e conomic consequences of general prostate cancer screening based on a l imited screening trial in a Swedish community and a decision-tree mode l. A random selection of 1492 men (50-69 years) were invited to repeat ed screening in 1987, They have been examined every third year (four r ounds). The other 7679 men in the population act as controls. The resu lts show that the total incremental health care costs for prostate cac er will increase by 179 million SEK per year with screening compared t o no-screening. The number of detected cases of localized cancer will increase by about 1000, which represents an additional cost of about 1 58 000 SEK per case. In conclusion, general screening for prostate can cer can be performed with a reasonable cost per detected localized can cer. Information on the long-term effect on life quality and cancer mo rtality is unknown. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.