TY - JOUR
T1 - Prostate cancer screening strategies with re-screening interval determined by individual baseline prostate-specific antigen values are cost-effective
AU - Kobayashi, T.
AU - Goto, R.
AU - Ito, K.
AU - Mitsumori, K.
PY - 2007/8/1
Y1 - 2007/8/1
N2 - Aims: To determine whether prostate cancer screening strategies with re-screening interval determined by individual baseline prostate-specific antigen values are cost-effective. Methods: Based on the results of an actual contemporary screening program, we established Markov decision analytic models of prostate cancer screening with personalized re-screening interval strategies using cutoff baseline PSA levels for biennial screening as well as a model of uniformly annual or biennial screening. These strategies were compared in terms of cumulative incidence of early cancer and cost-effectiveness. Results: Early cancer detection rates were similar among all strategies. Personalized strategies were more cost-effective compared to uniform screening strategies. If all participants with negative PSA results uniformly omit annual screening, it would be more costly but less effective (dominated). Contrary, annual screening for all participants would cost too much. These results were robust throughout sensitivity analysis incorporating every assumption in the models. Conclusions: This study adds important evidence that personalized rescreening strategies based on individual baseline PSA have advantages of cost-effectiveness against conventional uniform strategies.
AB - Aims: To determine whether prostate cancer screening strategies with re-screening interval determined by individual baseline prostate-specific antigen values are cost-effective. Methods: Based on the results of an actual contemporary screening program, we established Markov decision analytic models of prostate cancer screening with personalized re-screening interval strategies using cutoff baseline PSA levels for biennial screening as well as a model of uniformly annual or biennial screening. These strategies were compared in terms of cumulative incidence of early cancer and cost-effectiveness. Results: Early cancer detection rates were similar among all strategies. Personalized strategies were more cost-effective compared to uniform screening strategies. If all participants with negative PSA results uniformly omit annual screening, it would be more costly but less effective (dominated). Contrary, annual screening for all participants would cost too much. These results were robust throughout sensitivity analysis incorporating every assumption in the models. Conclusions: This study adds important evidence that personalized rescreening strategies based on individual baseline PSA have advantages of cost-effectiveness against conventional uniform strategies.
KW - Cost-effectiveness
KW - Decision-analytic model
KW - Mass screening
KW - Prostate neoplasms
KW - Prostate-specific antigen (PSA)
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U2 - 10.1016/j.ejso.2007.02.015
DO - 10.1016/j.ejso.2007.02.015
M3 - Article
C2 - 17408910
AN - SCOPUS:34447107949
VL - 33
SP - 783
EP - 789
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
IS - 6
ER -