@misc{10481/112742,
year = {2007},
month = {11},
url = {https://hdl.handle.net/10481/112742},
abstract = {Objective: To assess the cost-effectiveness of two diagnostic strategies for prostate cancer in men with prostate-specific antigen (PSA) levels of 4–10 ng/ml and normal digital rectal examination (DRE). Design: Cost-effectiveness analysis was performed using a decision tree model. Data collection and a systematic review of patients at the Urology Department (Carlos Haya Hospital) were made. 101 patients over the age of 40 with PSA levels of 4–10 ng/ml and normal DRE were selected. Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and percent free PSA testing prior to TRUS-Bx were performed. The outcome measures used were the incremental cost-effectiveness ratio, and costs were calculated through activity-based costing. The effectiveness was measured by means of the number of detected cases, test utility and actual cases (detected cases minus lost cases). Results: Using base-case analysis, the strategy of percent free PSA + TRUS-Bx was found to be the most cost-effective. The incremental cost-effectiveness ratio for free PSA + TRUS-Bx compared with TRUS-Bx was EUR 2,277.40. Strategy 2 (TRUS-Bx) would be more cost-effective if the cost of percent free PSA increased to EUR 21.64 or if prostate cancer prevalence increased to 26%. Conclusions: The use of percent free PSA prior to TRUS-Bx is the most cost-effective diagnostic strategy. However, this result is very sensitive and strategy 2 (TRUS-Bx) would be more cost-effective if the cost of the percent free PSA increased to EUR 21.64 or if the prevalence of prostate cancer increased to above 26%.},
organization = {Epidemiology and Public Health Centers Network},
publisher = {Karger},
keywords = {Prostate cancer},
keywords = {Prostate-specific antigen, percent free},
keywords = {Cost analysis},
title = {Cost-effectiveness of percent free PSA for prostate cancer detection in men with a total PSA of 4-10 ng/ml},
doi = {10.1159/000109720},
author = {Bermúdez Tamayo, Clara and Martín Martín, José Jesús and López Del Amo González, María Del Puerto and Pérez Romero, Carmen},
}