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In the meantime, you can enjoy access to all the latest news, events and resources for different therapy areas on our website.Economic analysis of prostatespecific antigen screening and treatment strategies
In 2012, the US Preventive Services Task Force recommended against the use of routine prostate-specific antigen (PSA) screening for prostate cancer.1
A recent study published in JAMA Oncology analysed the cost-effectiveness of PSA screening and the added value of conservative management for low-risk, screen-detected cases of prostate cancer.1
This study utilised a microsimulation model of prostate cancer incidence and mortality to simulate 18 strategies for PSA screening beginning at 40 years of age.1
The authors used the model to calculate the following outcomes for each screening strategy: prostate cancer diagnosis, treatment, death, unadjusted life-years (LYs), quality-adjusted life-years (QALYs) and costs.1
All of the 18 screening strategies led to increased costs ($314–$1,371) and LYs (0.03–0.06) compared with no screening.1
Cost of screening strategies ranged from $11,977 to $21,649 per LY.1
With contemporary treatment (based on patient age and cancer stage), QALYs were increased (0.002–0.004) only with screening strategies with a biopsy referral threshold of PSA ≥10.0 ng/mL or with age-based thresholds.1
For selective treatment (based on Gleason score and clinical progression), all screening strategies led to increased QALYs (0.002–0.004).1
With selective treatment, some of the screening strategies may be cost-effective in terms of cost per QALY.1
With selective treatment practices, screening thresholds of PSA <10.0 ng/mL showed increased costs ($263–$703) but also increased QALYS (0.002–0.004).1
The researchers found that a screening strategy with an interval of every 4 years, changing to every 2 years if PSA >1.0 ng/mL, had an incremental cost-effectiveness ratio of $136,332 per QALY gained that compared favourably with no screening.1
The authors concluded that in order for PSA screening and biopsy to be costeffective, it should be used conservatively with less frequent screening, more restrictive criteria for biopsy and in combination with selective treatment strategies.1
