Based on the findings in an early detection study for prostate cancer [Gustafsson et al. : J Urol 148 : 1827-1831,1992] using digital rectal examination (DRE), transrectal ultrasound (TRUS), and prostate-specific antigen (PSA), a cost-effectiveness analysis was performed based on 6 screening strategies, namely : 1) DRE of all individuals ; 2) TRUS of all individuals ; 3) DRE, TRUS, and PSA analysis followed by reexamination of individuals with PSAs =7 ng/ml ; 4) DRE of individuals with PSAs of =4 ng/ml ; 5) TRUS of individuals with PSAs of =4 ng/ml ; 6) DRE and PSA analysis followed by TRUS on individuals with PSAs =4 ng/ml.
The detection rates of prostate cancer using these 6 strategies were 2.4%, 3.3%, 3.6%, 2.0%, 2.6%, and 3.2%, respectively.
Except for costs per detected cancer, costs were also calculated per detected small cancer (¾1.5 cm) and per detected cancer treated for cure.
The cost calculations were based on total costs, i.e., direct plus indirect costs.
When the 6 strategies were compared, taking into account the detection rate of cancers treated for cure and cost-effectiveness with respect to cancers treated for cure, strategies 1), 2), 3), and 4) were ruled out as less favorable than the remaining 2 strategies.
TRUS of individuals with PSAs =4 ng/ml (strategy 5) was the most cost-effective strategy and detected 80% of the cancers actually treated for cure.
Mots-clés Pascal : Epithélioma, Prostate, Analyse coût efficacité, Economie santé, Semenogelase, Exploration clinique, Echographie, Etude comparative, Dépistage, Exploration, Homme, Mâle, Suède, Serine endopeptidases, Proteinases, Hydrolases, Enzyme, Europe, Appareil urinaire pathologie, Appareil génital mâle pathologie, Prostate pathologie, Tumeur maligne, Exploration immunologique, Exploration ultrason
Mots-clés Pascal anglais : Carcinoma, Prostate, Cost efficiency analysis, Health economy, Semenogelase, Clinical investigation, Echography, Comparative study, Medical screening, Exploration, Human, Male, Sweden, Serine endopeptidases, Proteinases, Hydrolases, Enzyme, Europe, Urinary system disease, Male genital diseases, Prostate disease, Malignant tumor, Immunological investigation, Sonography
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0467803
Code Inist : 002B30A03B. Création : 01/03/1996.