Systematic Review on the Cost Effectiveness of Prostate Cancer Screening in Europe
Pieter Vynckier, Lieven Annemans, Sarah Raes, Cheïma Amrouch, Peter Lindgren, Ondřej Májek, Katharina Beyer, R. Leenen, Lionne D. F. Venderbos, Frederique Denijs, Meike J. van Harten, Jozien Helleman, Renata Chloupková, Erik Briers, Vera Vasilyeva, Juan Gómez Rivas, Partha Basu, Arunah Chandran, Roderick C.N. van den Bergh, Sarah Collen, Hein Van Poppel, Monique J. Roobol, Hendrik Van Poppel, Sarah Collen, James N’Dow, Phillip Cornford, Juan Gómez Rivas, Monique Roobol-Bouts, Katharina Beyer, Lionne D. F. Venderbos, Jozien Helleman, R. Leenen, Daan Nieboer, Esmee F. H. Mulder, Jeroen Lodder, Frederique Denijs, Roderick van den Bergh, Kirsi Talala, Pia Kirkegaard, Berit Andersen, Mette Bach Larsen, Sofie Meyer Andersen, Grace McKinney, Karel Hejduk, Ondřej Májek, Ondřej Ngo, Tomáš Vyskot, Marcela Koudelková, Roman Zachoval, Renata Chloupková, Kateřina Hejcmanová, Meike van Harten, Peter-Paul Willemse, Norbert Couespel, Riccardo Moschetti, Mike Morrissey, Richard Price, Enea Venegoni, Agnese Konusevska, Otilia Colceriu, Zoë Parker, Dorota Dudek-Godeau, Malgorzata Krynicka, Krzysztof Tupikowski, Katarzyna Hodyra‐Stefaniak, Monika Litwin, Monika Pajewska, Aleksandra Czerw, Andrzej Deptała, Ángel Gómez Amorín, Silvia Suárez Luque, Carmen Durán Parrondo, A. Antelo, Montserrat Corujo Quinteiro, Josep Vilaseca, Gemma Cuberas Borrós, Anna Arnau Bartés, Juan Pablo Salazar, H. López llauradó, Ola Bratt, Rebecka Arnsrud Godtman, Emil Järbur, Thomas Jiborn, Anders Bjartell, Anna Holst, Max Alterbeck, Aušvydas Patašius, Gintare Miksiene, Giedrė Smailytė, Ugne Mickeviciute, Lieven Annemans, Pieter-Jan Hutsebaut, Pieter Vynckier, R Kidd, M D O’Brien, Paula Keon, Carolyne Lynch, Michael K. Rooney, Martin Kivi, David Galvin
Abstract
BACKGROUND AND OBJECTIVE: In Europe, prostate cancer (PCa) is the most common cancer in men. Screening may therefore be crucial to lower health care costs, morbidity, and mortality. This systematic review aimed to provide a contemporary overview of the costs and benefits of PCa screening programmes. METHODS: A peer-reviewed literature search was conducted, using the PICO method. A detailed search strategy was developed in four databases based on the following key search terms: "PCa", "screening", and "cost effectiveness". Any type of economic evaluation was included. The search strategy was restricted to European countries, but no restrictions were set on the year of publication. KEY FINDINGS AND LIMITATIONS: A total of 7484 studies were identified initially. Of these, 19 studies described the cost effectiveness of PCa screening in Europe. Among the studies using an initially healthy study population, most focussed on risk- and/or age- and/or magnetic resonance imaging (MRI)-based screening in addition to prostate-specific antigen (PSA) testing and compared this with no screening. Incremental cost ratios (ICERs) varied from €5872 per quality-adjusted life year (QALY) to €372 948/QALY, with a median of €56 487/QALY. Risk-based screening followed by MRI testing seemed to be a more cost-effective strategy than no screening. CONCLUSIONS AND CLINICAL IMPLICATIONS: This systematic review indicates that screening programmes incorporating a risk-based approach and MRI have the potential to be cost effective. PATIENT SUMMARY: In this review, we looked at the cost effectiveness of prostate cancer screening in Europe. We found that a risk-based approach and incorporation of magnetic resonance imaging has the potential to be cost effective. However, there remains a knowledge gap regarding cost effectiveness of prostate cancer screening. Therefore, determinants of cost effectiveness require further investigation.