Accession Number:

ADA610807

Title:

Decision Analysis of the Benefits and Costs of Screening for Prostate Cancer

Descriptive Note:

Annual summary rept. 27 Jul 2009-26 Jul 2014

Corporate Author:

DANA-FARBER CANCER INST BOSTON MA

Personal Author(s):

Report Date:

2014-08-01

Pagination or Media Count:

29.0

Abstract:

Observation has emerged as a strategy to avoid overtreatment in men with screen-detected low-risk prostate cancer CaP. This analysis examines the cost-effectiveness of observation with watchful waiting WW as experienced in the PIVOT study or active surveillance AS, radical prostatectomy RP, radiation therapy IMRT, and brachytherapy BT in these men. METHODS A Markov Monte Carlo model was constructed. Main outcomes were costs 2012US and quality-adjusted life-years QALYs for men aged 65 and 75 years. RESULTS Observation was more effective and less costly than initial treatment. Compared with AS, WW provided 2 additional months of QALE 9.02 vs. 8.85 y at a savings of 15374 24520 vs. 39894 in men aged 65 and 6.14 vs. 5.98y at a savings of 11746 18302 vs. 30048 in men aged 75. BT was the most effective and least expensive initial treatment. Treatment became more effective than observation when it led to greater reductions in CaP death hazard ratio, 0.47 vs. WW 0.64 vs. AS. AS became as effective as WW in men aged 65 when the probability of progressing to treatment on AS decreased below 63 or when the quality of life with AS versus WW was 4 higher in men aged 65. WW remained least expensive in all analyses

Subject Categories:

  • Economics and Cost Analysis
  • Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE