Cost-effectiveness of prostate cancer screening: a simulation study based on ERSPC data
| Autor: | C.H. Bangma, L. Denis, Jonas Hugosson, Vera Nelen, Monique J. Roobol, Anssi Auvinen, Maciej Kwiatkowski, Sigrid Carlsson, A. Villers, Elisabeth M. Wever, Eveline A.M. Heijnsdijk, Fritz H. Schröder, Teuvo L.J. Tammela, Marco Zappa, T. M. de Carvalho, A. Páez, S. M. Moss, F. Recker, H.J. de Koning |
|---|---|
| Přispěvatelé: | Public Health, Urology |
| Rok vydání: | 2014 |
| Předmět: |
Oncology
Male Cancer Research medicine.medical_specialty Time Factors Cost effectiveness Cost-Benefit Analysis Article Prostate cancer SDG 3 - Good Health and Well-being Internal medicine medicine Biomarkers Tumor Humans Mass Screening Computer Simulation False Positive Reactions Overdiagnosis Mass screening Early Detection of Cancer Aged Gynecology business.industry Age Factors Cancer Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease Annual Screening Europe Prostate-specific antigen Prostate cancer screening Quality of Life Quality-Adjusted Life Years business |
| Zdroj: | Journal of the National Cancer Institute, 107(1). Oxford University Press Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid |
| ISSN: | 1460-2105 0027-8874 |
| Popis: | The European Randomized study of Screening for Prostate Cancer (ERSPC) has shown a disease-specific mortality reduction of prostate-specific antigen (PSA) screening for prostate cancer (1). After eleven years of follow-up, prostate cancer mortality was reduced by 29% after adjustment for noncompliance. In terms of absolute effect, 37 cancers would need to be detected to avert one prostate cancer death (1). Some of the screen-detected prostate tumors (23% to 42%) might never give rise to clinical symptoms and would not lead to death from prostate cancer (2). These overdetected cancers reduce quality of life and result in higher costs because of overtreatment (3), affecting the balance of benefits and harms as well as cost-effectiveness of PSA testing for prostate cancer. In our recent study, we demonstrated that the introduction of a screening program between the ages of 55 to 70 with a four-year interval would result in a gain of 52 life-years and 41 quality-adjusted life-years (QALYs) per 1000 men over their life span (a 23% negative impact on the life-years gained because of quality of life [4]). Very recently the American Urological Association (AUA) recommended shared decision-making for men age 55 to 69 years who are considering PSA screening, but they gave no clear indication of the screen interval. In the ERSPC, the Swedish center used a two-year screening interval, whereas the other centers used four-year intervals (1). In the United States, annual screening is more common. There are no trials comparing different screening intervals, and such empirical studies are highly unlikely to be conducted because of the immense resources required. Few recent cost-effectiveness studies have been published using QALYs gained. Most cost-effectiveness studies for prostate cancer screening have been performed before large screening trial results had been published and showed very inconsistent results (5,6). The aim of this study was to assess the cost-effectiveness of prostate cancer screening. Based on data of the ERSPC trial various prostate cancer screening strategies were modeled to find the optimal screening intervals and ages. |
| Databáze: | OpenAIRE |
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