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): | 3.0Â ng/ml | Â | 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 $50–80,000/QALY gained |
 | · screen at 50, 60, 70 | 3.0 ng/ml | Dominated | ||
 | · screen at 60 followed by screen at 65 | 3.0 ng/ml | Dominated | ||
 | · screen every 4 years 55–69, 50–74 | 3.0 ng/ml | Dominated | ||
 | · screen every 4 years 50–74 | 3.0 ng/ml, (4.0 ng/ml for ≥70 years old) | Dominated | ||
 | · screen every 2 years 60–74, 50–69, 55–74, 50–74, 40–74 | 3.0 ng/ml | Dominated | ||
 | · screen every 2 years 50–74 | 3.0 ng/ml, (4.0 ng/ml for ≥70 years old) | Dominated | ||
 | · adaptive screen 50–74 | 3.0 ng/ml | Dominated | ||
Roth et al. [28] | US | 18 scenarios: Contemporary treatment scenario | Â | Â | Â |
 | · screen yearly 45–69, 50–74, 55–69 | 4.0 ng/ml | Dominated | US$ 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 |