A quantitative analysis of the costs and benefits of prostate cancer screening

Citation
Rm. Benoit et al., A quantitative analysis of the costs and benefits of prostate cancer screening, PROSTATE C, 4(3), 2001, pp. 138-145
Citations number
36
Categorie Soggetti
Urology & Nephrology
Journal title
PROSTATE CANCER AND PROSTATIC DISEASES
ISSN journal
13657852 → ACNP
Volume
4
Issue
3
Year of publication
2001
Pages
138 - 145
Database
ISI
SICI code
1365-7852(2001)4:3<138:AQAOTC>2.0.ZU;2-P
Abstract
The present study attempts to, quantitate, in an economically and clinicall y meaningful manner the cost and cost-effectiveness of prostate cancer scre ening and subsequent treatment, including complications from that treatment . Outcome data from large prostate cancer screening trials using prostate s pecific antigen (PSA) and digital rectal examination (DRE) and PSA alone we re used to construct the screening, model. The benefit of screening is expr essed in years of life saved by screening, which is calculated by comparing the survival rate of men with prostate cancer to the survival rate of men in the general population. The cost of screening, treatment, and complicati ons, were estimated using the Medicare data base. and published reports on the cost, morbidity and mortality for radical prostatectomy. The cost per y ear of life saved by prostate cancer screening with PSA and DRE was $2339-3 005, for men aged 50-59, $3905-5070 for men aged 60-69, and $3574-4627 over all for men aged 50-69. The cost per year of life saved by prostate cancer screening with PSA alone for men aged 50-70 was $3822-4956. A sensitivity a nalysis demonstrates that the cost per year of life saved by prostate cance r screening will not change substantially even if the assumptions in this, model have been underestimated or overestimated by 100%. This study quantif ies only those parameters which can be reliably compared in concrete terms such as dollars, treatment impact on survival, published complication rates and published treatment costs. Using this type of analysis, prostate cance r screening appears to, be a cost-effective intervention. However, the issu e of whether prostate cancer screening is cost-effective will be decided de finitively only when randomized, controlled trials are available to quantif y the costs and benefits, of prostate cancer screening.