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Prostate-Specific Antigen (PSA)-Based Population Screening for Prostate Cancer: An Economic Analysis.
Ontario Health Technology Assessment Series
|September 15, 2015
Summary
Prostate-specific antigen (PSA) screening for prostate cancer is costly and may not improve survival. Ontario spends over $119 million annually on opportunistic PSA screening, with a population-based program costing an estimated $149 million in its first year.
Area of Science:
- Health Economics
- Oncology
- Public Health Policy
Background:
- Prostate-specific antigen (PSA) testing is prevalent in Canada for prostate cancer (PC) detection.
- Evidence suggests population-based PSA screening may not enhance overall survival rates.
Purpose of the Study:
- To review economic evaluations of population-based PSA screening.
- To determine current expenditures on opportunistic PSA screening in Ontario.
- To estimate the cost of implementing a population-based PSA screening program in Ontario.
Main Methods:
- Systematic literature search for economic evaluations of PSA screening (1998-2013).
- Assessment of study quality and applicability to Ontario.
- Original cost analysis using Ontario administrative data and literature.
- Estimation of one-year costs for four screening strategies from a payer perspective.
Main Results:
- Population-based PSA screening is generally costly and cost-ineffective, though potentially beneficial for specific groups.
- Ontario currently spends approximately $119.2 million annually on opportunistic PSA screening.
- A first-year cost of $149.4 million is estimated for a population-based screening program in Ontario.
Conclusions:
- PSA screening incurs substantial healthcare costs, including testing, diagnosis, staging, and treatment.
- Uncertainty exists in cost estimations due to reliance on varied data sources and assumptions.
- The cost-effectiveness of PSA screening varies, with potential benefits in targeted populations.
