[Cost-effectiveness analysis of prostatic cancer screening]

Abstract

Background: To evaluate how much mass screening for prostatic cancer (PC) would benefit the nation economically, cost-effectiveness of PC screening was analyzed.

Methods: The cost per life-year saved (cost-effectiveness ratio; CER) was compared between PC screening and other 5 already established cancer screenings in Japan by an analytical simulation model to estimate cost and effectiveness of various screening programs, which was proposed recently by Hisamichi and Kamae.

Results: Although CER in PC screening amounted 204 x 10(3) yen for males aged from 55 to 59 years of age, among males more than 60 years of age. CER became negative, which meant a positive balance might be obtained economically by the adoption of screening. CER of PC screening was similar to that of colorectal cancer screening, while was 2 to 14 times lower than that of the remaining 4 established cancer screenings. According to the sensitivity analysis, the rate of the prevalence of PC, as well as the rate of the examinees for the secondary study influenced remarkedly the cost-effectiveness of PC screening.

Conclusion: The morbidity and mortality of PC has seriously increased in the past years in Japan and the number of PC patients in 2015 is anticipated to show a 5.19-fold increase of that in 1990. According to such considerable increase of PC patients in the near future, PC screening is thought to be an economically well-balanced public activity.