Original Title: Análisis coste-efectividad del cribado del cáncer de próstata con antígeno prostático específico asociado o no al examen rectal digital en varones a partir de los 50 ańos

Authors' objectives: Determining the cost-effectiveness ratio of screening for prostate cancer including digital rectal examination (DRE), prostate-specific antigen (PSA) and the combination of both, compared with no screening and depending on the frequency of application of the test (annual interval or every 2, 3 and 4 years), using data from literature.

Authors' results and conclusions: RESULTS: The most efficient strategy (better cost-effectiveness ratio) consisted in doing the PSA. The incremental cost of annual PSA compared to no screening was € 4,373 per QALY gained and for PSA+DRE was € 33,429 per QALY. The DRE was dominated (more cost and less efficacy) by the PSA. The PSA test has better incremental cost-effectiveness each year than every 2, 3 and 4 years. CONCLUSIONS: The cost-effectiveness analysis in our study does not ratify the results of other previous studies that characterize prostate cancer screening as an intervention not effective. For the age group above 50 years of prostate cancer screening with PSA is cost-effective. In addition, it is also more efficient annual screening with PSA than every 2, 3 and 4 years.

Authors' methods: Decision model with a Markov process that considers 10 different health states: healthy, stage A cancer, stage B cancer, stage C cancer, stage D cancer, death, follow up post stage A, follow up post stage B, follow up post stage C, follow up post stage D. The transition probabilities, sensitivity, specificity, incidence, prevalence and mortality reduction was obtained from the literature. The time perspective was the whole life of the person. The utilities were obtained from the general population, a sample of patients and from the literature. The costs of screening, treatment and complications were obtained from different sources. The effectiveness was measured in terms of cost per quality adjusted life year (QALY) gain. We used a health service perspective. We did a sensitivity analysis.

Project Status: Completed

Year Published: 2010

URL for published report: https://sescs.es/analisis-coste-efectividad-del-cribado-del-cancer-de-prostata/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es