An overview cost-utility analysis of prostate cancer screening.

The value of prostate cancer screening remains controversial because of the high prevalence of the disease and the fact that many tumors detected through screening are not destined to lead to morbidity or mortality, rendering treatment unnecessary. An ongoing NCI-sponsored screening trial may eventually put an end to the controversy. However, in the meantime, cost-utility estimates suggest that the cost per crude and quality-adjusted life year gained from prostate cancer screening and treatment ranges from $8,400 to $23,100 (with an estimated 1 to 2.68 QALYs gained from screening and treatment), and that these estimates are actually lower than, or well within the range of, the costs of many commonly accepted medical interventions, including screening mammography in women under age 50 ($232,000) and treatment of hypertension with captopril ($82,600) or hydrochlorothiazide ($23,500). Thus, we conclude that prostate cancer screening may indeed be cost effective and should be offered to men in the at-risk age range.