UroToday - Cost-Effectiveness of Percent Free PSA for Prostate Cancer Detection in Men with a Total PSA of 4-10 ng/ml - Abstract

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Friday, 04 January 2008

Andalusian School of Public Health, Granada, Spain

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To assess the cost-effectiveness of two diagnostic strategies for prostate

cancer in men with prostate-specific antigen (PSA) levels of 4-10 ng/ml and

normal digital rectal examination (DRE).

Cost-effectiveness analysis was performed using a decision tree model. Data

collection and a systematic review of patients at the Urology Department

( Haya Hospital) were made. 101 patients over the age of 40 with PSA

levels of 4-10 ng/ml and normal DRE were selected. Transrectal

ultrasound-guided prostate biopsy (TRUS-Bx) and percent free PSA testing

prior to TRUS-Bx were performed. The outcome measures used were the

incremental cost-effectiveness ratio, and costs were calculated through

activity-based costing. The effectiveness was measured by means of the

number of detected cases, test utility and actual cases (detected cases

minus lost cases)

Using base-case analysis, the strategy of percent free PSA + TRUS-Bx was

found to be the most cost-effective. The incremental cost-effectiveness

ratio for free PSA + TRUS-Bx compared with TRUS-Bx was EUR 2,277.40.

Strategy 2 (TRUS-Bx) would be more cost-effective if the cost of percent

free PSA increased to EUR 21.64 or if prostate cancer prevalence increased

to 26%

The use of percent free PSA prior to TRUS-Bx is the most cost-effective

diagnostic strategy. However, this result is very sensitive and strategy 2

(TRUS-Bx) would be more cost-effective if the cost of the percent free PSA

increased to EUR 21.64 or if the prevalence of prostate cancer increased to

above 26%. © 2007 S. Karger AG, Basel.

Written by

Bermúdez-Tamayo C, Martín Martín JJ, González Mdel P, Pérez Romero C.

Reference

Urol Int. 2007;79(4):336-44

doi:10.1159/000109720

PubMed Abstract

PMID:18025853

http://www.urotoday.com/61/browse_categories/prostate_cancer/costeffectivene

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