Early prostate cancer: diagnostic costs of screening transrectal US and digital rectal examination

A screening study with transrectal ultrasound (US) and digital rectal examination to diagnose early prostate cancer was performed to calculate diagnostic costs. The total costs of screening 784 men were $130,400 with transrectal US and $41,080 with digital rectal examination. Per diagnosed cancer, the costs were $6,520 for transrectal US and $4,108 for digital rectal examination, a difference of 37%. The costs per early diagnosed cancer (stage A or B) were $7,671 and $5,869 for transrectal US and digital rectal examination, respectively--a difference of 23%. The costs per early cancer that would have been advanced if diagnosed without screening were $22,177 for transrectal US and $28,528 for digital rectal examination--a difference of 22% in favor of transrectal US. Equations for these relative costs were generated for transrectal US and digital rectal examination. Costs are related to changes in prevalences and to changes in the stages of prostate cancer when diagnosed without screening.