Prostate cancer screening strategies with re-screening interval determined by individual baseline prostate-specific antigen values are cost-effective
Prostate cancer screening strategies with re-screening interval determined by individual baseline prostate-specific antigen values are cost-effective
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DOI：
10.1016/j.ejso.2007.02.015
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发表时间：
2007-08-01
期刊：
影响因子：
3.8
通讯作者：
Mitsumori, K.
中科院分区：
文献类型：
--
作者：
Kobayashi, T.;Goto, R.;Mitsumori, K.
目的：确定由个体基线前列腺特异性抗原值确定的前列腺癌筛查策略是否具有成本效益。方法：根据当代实际筛查计划的结果，我们建立了前列腺癌筛查的马尔可夫决策分析模型，采用两年一次筛查的截止基线 PSA 水平以及统一的每年或每两年一次的模型，采用个性化的重新筛查间隔策略。 筛选。对这些策略的早期癌症累积发病率和成本效益进行了比较。结果：所有策略的早期癌症检出率相似。与统一的筛查策略相比，个性化策略更具成本效益。如果所有 PSA 结果为阴性的参与者都统一省略年度筛查，成本会更高，但效果会较差（占主导地位）。相反，每年对所有参与者进行筛查的成本太高。这些结果在纳入模型中每个假设的敏感性分析中都是稳健的。结论：这项研究提供了重要的证据，表明基于个体基线 PSA 的个性化重新筛选策略相对于传统的统一策略具有成本效益的优势。 (c) 2007 Elsevier Ltd. 保留所有权利。
Aims: To determine whether prostate cancer screening strategies with re-screening interval determined by individual baseline prostatespecific antigen values are cost-effective.Methods: Based on the results of an actual contemporary screening program, we established Markov decision analytic models of prostate cancer screening with personalized re-screening interval strategies using cutoff baseline PSA levels for biennial screening as well as a model of uniformly annual or biennial screening. These strategies were compared in terms of cumulative incidence of early cancer and cost-effectiveness.Results: Early cancer detection rates were similar among all strategies. Personalized strategies were more cost-effective compared to uniform screening strategies. If all participants with negative PSA results uniformly omit annual screening, it would be more costly but less effective (dominated). Contrary, annual screening for all participants would cost too much. These results were robust throughout sensitivity analysis incorporating every assumption in the models.Conclusions: This study adds important evidence that personalized rescreening strategies based on individual baseline PSA have advantages of cost-effectiveness against conventional uniform strategies. (c) 2007 Elsevier Ltd. All rights reserved.