Cost-Effectiveness Analysis of Prostate Cancer Screening in the UK: A Decision Model Analysis Based on the CAP Trial

Edna Keeney (), Sabina Sanghera, Richard M. Martin, Roman Gulati, Fredrik Wiklund, Eleanor I. Walsh, Jenny L. Donovan, Freddie Hamdy, David E. Neal, J. Athene Lane, Emma L. Turner, Howard Thom and Mark S. Clements
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Edna Keeney: University of Bristol
Sabina Sanghera: University of Bristol
Richard M. Martin: University of Bristol
Roman Gulati: Fred Hutchinson Cancer Research Center
Fredrik Wiklund: Karolinska Institute
Eleanor I. Walsh: University of Bristol
Jenny L. Donovan: University of Bristol
Freddie Hamdy: University of Oxford
David E. Neal: University of Oxford
J. Athene Lane: University of Bristol
Emma L. Turner: University of Bristol
Howard Thom: University of Bristol
Mark S. Clements: Karolinska Institute

PharmacoEconomics, 2022, vol. 40, issue 12, No 5, 1207-1220

Abstract: Abstract Background and Objective Most guidelines in the UK, Europe and North America do not recommend organised population-wide screening for prostate cancer. Prostate-specific antigen-based screening can reduce prostate cancer-specific mortality, but there are concerns about overdiagnosis, overtreatment and economic value. The aim was therefore to assess the cost effectiveness of eight potential screening strategies in the UK. Methods We used a cost-utility analysis with an individual-based simulation model. The model was calibrated to data from the 10-year follow-up of the Cluster Randomised Trial of PSA Testing for Prostate Cancer (CAP). Treatment effects were modelled using data from the Prostate Testing for Cancer and Treatment (ProtecT) trial. The participants were a hypothetical population of 10 million men in the UK followed from age 30 years to death. The strategies were: no screening; five age-based screening strategies; adaptive screening, where men with an initial prostate-specific antigen level of

Date: 2022
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DOI: 10.1007/s40273-022-01191-1

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