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Table 2 Cost-effectiveness results for studies reporting QALYs

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

Study

Setting

Strategies compared

PSA threshold

ICER (Cost/QALY gained)

Threshold

Chilcott et al. [23]

UK

· single screen at 50

3.0 ng/ml

Dominateda

£20–30,000/QALY gained

 

· screen every 4 years from 50 to 74 years

3.0 ng/ml

Dominated

 

· screen every 2 years 50–74 years

3.0 ng/ml

Dominated

 

· screen every year from 50 to 74

3.0 ng/ml

Dominated

 

· screen at 50, 60, 65, 70

3.0 ng/ml

Dominated

 

· screen every 4 years 50–70, 55–74, 55–70

3.0 ng/ml

Dominated

 

· screen every 2 years 50–70, 55–74, 55–70

3.0 ng/ml

Dominated

Heijnsdijk et al. [25]

Costs in US dollars

NR

68 scenarios (efficient strategies only):

3.0 ng/ml

 

No formal threshold

 

· single screen at 55 years

3.0 ng/ml

$31,467

 

· screen at 55 and then 57 years

3.0 ng/ml

$38,563

 

· screen at 55 and then 58 years

3.0 ng/ml

$40,785

 

· screen every 2 years 55–59 years

3.0 ng/ml

$45,615

 

· screen every 2 years 55–61 years

3.0 ng/ml

$54,349

 

· screen yearly 55–61 years

3.0 ng/ml

$63,263

 

· screen yearly 55–62 years

3.0 ng/ml

$69,481

 

· screen yearly 55–63 years

3.0 ng/ml

$76,910

Hummel and Chilcott [24]

UK

· single screen at 50

3.0 ng/ml

Dominated

£20–30,000/QALY gained

 

· screen every 4 years from 50 to 74 years

3.0 ng/ml

Dominated

 

· screen every 2 years 50–74 years

3.0 ng/ml

Dominated

 

· screen every year from 50 to 74 years

3.0 ng/ml

Dominated

Keller et al. [29]

Australia

· opportunistic screening (current practice)

3.0 ng/ml to 2.5 ng/ml

 

A$50,000/QALY gained

 

· screen every 2 years from 50 to 69 years (immediate treatment)

3.0 ng/ml to 2.5 ng/ml

A$147,528

 

· screen every 2 years from 50 to 69 years (AS for low risk cancer)

 

A$45,882

Kobayashi et al. [27]

Costs in US dollars

NR

· annual screen irrespective of baseline, 50–70

N/A

$165,938

No formal threshold

 

· baseline PSA ≤ 1.0 ng/ml biennial rescreening, 50–70

1.0 ng/ml

$46,505

 

· baseline PSA ≤ 2.0 ng/ml biennial rescreening, 50–70

2.0 ng/ml

$5925

 

· baseline PSA ≤ 3.0 ng/ml biennial rescreening, 50–70

3.0 ng/ml

 
 

· baseline PSA ≤ 4.0 ng/ml biennial rescreening. 50–70

4.0 ng/ml

Dominated

Martin et al. [30]

Australia

· average risk screen: every 4 years, 50+

4.0 ng/ml

A$291,817

A$50,000/QALY gained

 

· high risk screen: every 4 years, 50+

4.0 ng/ml

A$110,726

 

· very high risk screen: every 4 years, 50+

4.0 ng/ml

A$30,572

Pataky et al. [26]

Canada

14 scenarios:

  

CAN $50–80,000/QALY gained

 

· screen at 50, 60, 70

3.0 ng/ml

Dominated

 

· screen at 60 followed by screen at 65

3.0 ng/ml

Dominated

 

· screen every 4 years 55–69, 50–74

3.0 ng/ml

Dominated

 

· screen every 4 years 50–74

3.0 ng/ml, (4.0 ng/ml for ≥70 years old)

Dominated

 

· screen every 2 years 60–74, 50–69, 55–74, 50–74, 40–74

3.0 ng/ml

Dominated

 

· screen every 2 years 50–74

3.0 ng/ml, (4.0 ng/ml for ≥70 years old)

Dominated

 

· adaptive screen 50–74

3.0 ng/ml

Dominated

Roth et al. [28]

US

18 scenarios: Contemporary treatment scenario

   
 

· screen yearly 45–69, 50–74, 55–69

4.0 ng/ml

Dominated

US$ 50,000-150,000/QALY gained typically referred to (study refers to $150,000/QALY gained)

 

· screen yearly 45–69

10.0 ng/ml

US $326,292

 

· screen yearly 50–74

10.0 ng/ml

US $330,065

 

· screen yearly 55–69

10.0 ng/ml

US $300,884

 

· screen yearly if >3.0 ng/ml, every 2 years otherwise,45–69

3.0 ng/ml

Dominated

 

· screen yearly if >3.0 ng/ml, every 2 years otherwise,45–69

10.0 ng/ml

US $184,074

 

· screen every 4 years 50–74

4.0 ng/ml

Dominated

 

· screen every 4 years 50–74

10.0 ng/ml

US $170,195

 

· screen every 4 years 55–69

10.0 ng/ml

US$92,446

 

· screen every 2 years if >1.0 ng/ml, every 4 years otherwise, 50–74

4.0 ng/ml

Dominated

 

· screen every 2 years if >1.0 ng/ml, every 4 years otherwise, 50–74

10.0 ng/ml

US $209,338

 

· screen yearly with age dependent threshold, 50–74

3.5(50–59), 4.5(60–69), 6.5(70–74)

Dominated

 

· screen yearly with age dependent threshold 50–74

4.5(50–59), 5.5(60–69), 8.5(70–74)

Dominated

 

· screen every 2 years 55–69

3.0 ng/ml

Dominated

 

· screen every 4 years 55–69

3.0 ng/ml

Dominated

 

· screen every 2 years 55–69

10.0 ng/ml

US $170,981

 

Selective treatment scenarios

  
 

· screen yearly 45–69

4.0 ng/ml

US $163,214

 

· screen yearly 50–74

4.0 ng/ml

US $243,768

 

· screen yearly 55–69

4.0 ng/ml

US $128,680

 

· screen yearly if >3.0 ng/ml, every 2 years otherwise,45–69

3.0 ng/ml

US $313,214

 

· screen every 4 years 50–74

4.0 ng/ml

US $89,333

 

· screen every 2 years if >1.0 ng/ml, every 4 years otherwise, 50–74

4.0 ng/ml

US $136,332

 

· screen yearly with age dependent threshold, 50–74

3.5(50–59), 4.5(60–69), 6.5(70–74)

US $166,784

 

· screen yearly with age dependent threshold 50–74

4.5(50–59), 5.5(60–69), 8.5(70–74)

US $124,564

 

· screen every 2 years 55–69

3.0 ng/ml

US $120,952

 

· screen every 4 years 55–69

3.0 ng/ml

US $70,831

  1. Italicised text indicates potentially cost-effective scenario. a Dominated; the strategy is more costly and less effective than the comparator (commonly, usual practice)