Date on Master's Thesis/Doctoral Dissertation

5-2006

Document Type

Master's Thesis

Degree Name

M.S.

Department

Bioinformatics and Biostatistics

Committee Chair

McCabe, Steven J.

Subject

Prostate--Cancer--Diagnosis--Cost effectiveness; Medical screening--Cost effectiveness

Abstract

Prostate cancer is a common form of cancer in men. In fact, prostate cancer has the highest incidence of any cancer in men. Prostate cancer is not only common, it carries a significant financial burden. The cost of prostate cancer is 11.3% of all cancer expenditures. If after a DRE the prostate is enlarged, or if the PSA is elevated, then a biopsy of the prostate would be recommended. Under the best of circumstances, cancer diagnoses will be missed and many will undergo unnecessary biopsy, etc. The focus of this paper was the cost-utility of screening with the PSA test. The cost differences between screening and not screening was compared. A Markov analysis and a Monte Carlo simulation were utilized to provide a basis for conclusion. The primary finding is that the costs associated with screening are much higher than those of not screening. Additional findings are that the specificity of the PSA test, the first year treatment costs, and the utility/outcomes of screening have an impact on the cost-utility of screening. The conclusion, however, is that the improvements in these factors would have to be significant to impact the case for screening. Until longitudinal studies are completed, it is not cost-effective to screen for prostate cancer.

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