Skip to main content

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)