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Table 1 Study characteristics

From: Cost-effectiveness of prostate cancer screening: a systematic review of decision-analytical models

Study Setting Population Strategies compared PSA threshold Treatment Outcome measure
Chilcott et al. [23] UK Men aged 50–74 · single screen at 50
· screen every 4 years from 50 to 74 years
· screen every 2 years 50–74 years
· screen every year from 50 to 74
· screen at 50, 60, 65, 70
· screen every 4 years 50–70, 55–74, 55–70
· screen every 2 years 50–70, 55–74, 55–70
3.0 ng/ml
3.0 ng/ml
3.0 ng/ml
3.0 ng/ml
3.0 ng/ml
3.0 ng/ml
3.0 ng/ml
· prostatectomy with ADT
· radiotherapy with ADT
· prostatectomy without ADT
· radiotherapy without ADT
· watchful waiting
· active monitoring
Cost per QALY gained
Heijnsdijk et al. [25] NR Men aged 55–75 68 scenarios: 3.0 ng/ml · radiotherapy Cost per QALY gained
   · starting at age 55; screen intervals at 1, 2, 3, 4, 6, 8, 10, 12, 14 years 3.0 ng/ml · prostatectomy
   · once in a lifetime 3.0 ng/ml · active surveillance
   · age at stopping was varied 55–75 years 3.0 ng/ml · metastases: palliative care
Hummel and Chilcott [24] UK Men aged 50–74 · single screen at 50: 3.0 ng/ml · radiotherapy (with and without hormone therapy) Cost per QALY gained
   · screen every 4 years from 50 to 74 years 3.0 ng/ml · prostatectomy (with and without hormone therapy)
   · screen every 2 years 50–74 years 3.0 ng/ml · watchful waiting
   · screen every year from 50 to 74 years 3.0 ng/ml · active monitoring
Keller et al. [29] Australia Men aged 50–69 · opportunistic screening (current practice)
· screen every 2 years from 50 to 69 years
3.0 ng/ml to 2.5 ng/mla · prostatectomy
· radiotherapy
· active surveillance
Cost per QALY gained
    3.0 ng/ml to 2.5 ng/mla · watchful waiting
One strategy with immediate treatment and one delayed based on Gleason score
Cost per life year gained
Kobayashi et al. [27] NR Men aged 50–70 · annual screen irrespective of baseline N/A no details on exact nature of treatments Cost per QALY gained
   · baseline PSA ≤ 1.0 ng/ml biennial rescreening 1.0 ng/ml  
   · baseline PSA ≤ 2.0 ng/ml biennial rescreening 2.0 ng/ml  
   · baseline PSA ≤ 3.0 ng/ml biennial rescreening 3.0 ng/ml  
   · baseline PSA ≤ 4.0 ng/ml biennial rescreening 4.0 ng/ml  
Martin et al. [30] Australia Men aged 50- (unclear) · average risk: screen every 4 years 4.0 ng/ml · radiotherapy (with and without hormone therapy) Cost per QALY gained
   · high risk: screen every 4 years 4.0 ng/ml · prostatectomy (with and without hormone therapy)
   · very high risk: screen every 4 years 4.0 ng/ml · conservative management
Pataky et al. [26] Canada Men aged 40–74 14 scenarios:   · radiotherapy (with and without hormone therapy) Cost per QALY gained and
   · Screen at 50, 60, 70 3.0 ng/ml · prostatectomy (with and without hormone therapy)
   · Screen at 60 followed by screen at 65 3.0 ng/ml · conservative management Cost per life year gained
   · screen every 4 years 55–69, 50–74 3.0 ng/ml  
   · screen every 4 years 50–74 3.0 ng/ml, (4.0 ng/ml for ≥70 years old)  
   · screen every 2 years 60–74, 50–69, 55–74, 50–74, 40–74 3.0 ng/ml  
   · screen every 2 years 50–74 3.0 ng/ml, (4.0 ng/ml for ≥70 years old)  
   · adaptive screen 50–74 3.0 ng/ml  
Roth et al. [28] US Men aged 45–69 18 scenarios:   (1) all cases receive curative surgery, radiotherapy with or without adjuvant hormone therapy, Cost per QALY gained and
   · screen yearly 45–69, 50–74, 55–69 4.0 ng/ml (2) Gleason < 7, <T2a receive conservative treatment or curative treatment, all others as above
   · screen yearly 45–69, 50–74, 55–69 10.0 ng/ml  
   · screen yearly if >3.0 ng/ml, every 2 years otherwise,45–69 3.0 ng/ml   Cost per life year gained
   · screen yearly if >3.0 ng/ml, every 2 years otherwise,45–69 10.0 ng/ml  
   · screen every 4 years 50–74 4.0 ng/ml  
   · screen every 4 years 50–74, 55–69 10.0 ng/ml  
   · screen every 2 years if >1.0 ng/ml, every 4 years otherwise, 50–74 4.0 ng/ml  
   · screen every 2 years if >1.0 ng/ml, every 4 years otherwise, 50–74 10.0 ng/ml  
   · screen yearly with age dependent threshold, 50–74 3.5(50–59), 4.5(60–69), 6.5(70–74)  
   · screen yearly with age dependent threshold 50–74 4.5(50–59), 5.5(60–69), 8.5(70–74)  
   · screen every 2 years 55–69 3.0 ng/ml  
   · screen every 4 years 55–69 3.0 ng/ml  
   · screen every 2 years 55–69 10.0 ng/ml  
Wolstenholme et al. [31] UK Men aged 50–65 · single screen at 50, 55, 60 and 65 3.0 ng/ml active surveillance, prostatectomy, radiotherapy, orchidectomy, hormonal therapy, chemotherapy Cost per life year saved/gained
   · screen every 5 years 50–65 3.0 ng/ml  
Shteynshlyuger & Andriole, [22] Europe Men aged 60–70 · “PSA screening reported in ERSPC”:   · Not reported. Assumed follows ERSPC trial Cost per life year saved
   · screen every 4 years 3.0 ng/ml or 4.0 ng/ml (depending on the centre)  
   · no such screening 3.0 ng/ml or 4.0 ng/ml (depending on the centre)  
  1. a The study is based on the Goteburg centre of the ERSPC trial, which altered the PSA threshold overtime to reflect current recommendations. ADT androgen deprivation therapy
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