Systematic Review on the Cost Effectiveness of Prostate Cancer Screening in Europe

• Published in: European urology Vol. 86; no. 5; pp. 400 - 408
• Main Authors: Vynckier, Pieter, Annemans, Lieven, Raes, Sarah, Májek, Ondřej, Leenen, Renée C.A., Venderbos, Lionne D.F., Denijs, Frederique, van Harten, Meike J., Helleman, Jozien, Chloupková, Renata, Briers, Erik, Vasilyeva, Vera, Rivas, Juan Gomez, Basu, Partha, Chandran, Arunah, van den Bergh, Roderick C.N., Collen, Sarah, Van Poppel, Hein, Roobol, Monique J., Van Poppel, Hendrik, N’Dow, James, Cornford, Phillip, Gómez Rivas, Juan, Roobol-Bouts, Monique, Beyer, Katharina, Venderbos, Lionne, Nieboer, Daan, Lodder, Jeroen, van den Bergh, Roderick, Talala, Kirsi, Kirkegaard, Pia, Andersen, Berit, Larsen, Mette Bach, Andersen, Sofie Meyer, McKinney, Grace, Hejduk, Karel, Ngo, Ondřej, Vyskot, Tomáš, Koudelková, Marcela, Chloupkova, Renata, Hejcmanova, Katerina, van Harten, Meike, Willemse, Peter-Paul, Couespel, Norbert, Moschetti, Riccardo, Morrissey, Mike, Price, Richard, Venegoni, Enea, Konusevska, Agnese, Colceriu, Otilia, Parker, Zoë, Dudek-Godeau, Dorota, Krynicka, Malgorzata, Tupikowski, Krzysztof, Hodyra-Stefaniak, Katarzyna, Litwin, Monika, Pajewska, Monika, Czerw, Aleksandra, Deptała, Andrzej, Amorín, Ángel Gómez, Luque, Silvia Suárez, Parrondo, Carmen Durán, Antelo, Ana Marina Tarrazo, Quinteiro, Montserrat Corujo, Borrós, Gemma Cuberas, Salazar, Juan Pablo, Llauradó, Hector López, Bratt, Ola, Godtman, Rebecka, Järbur, Emil, Jiborn, Thomas, Bjartell, Anders, Holst, Anna, Alterbeck, Max, Smailytė, Giedrė, Hutsebaut, Pieter-Jan, Kidd, Robert, O’Brien, Michael, Keon, Paula, Lynch, Carolyne, Kivi, Martin, Galvin, David, Sweeney, Paul, Frese, Thomas, Denny, Kathleen, O’Connor, Amy, Coghlan, Sarah, Carvalho, Andre, Singh, Deependra, Palaniraja, Sathishrajaa, Otero-García, Milagros, Lantz, Anna, Eneqvist, Lisa Jelf
• Format: Journal Article
• Language: English
• Published: Switzerland Elsevier B.V 01-11-2024; Elsevier Science
• Subjects: Cost effectiveness; Platinum priority – Prostate cancer – Editor’s choice; Prostate cancer; PRostate cancer Awareness and Initiative for Screening in the European Union; Screening; Screening; Cost effectiveness; Prostate cancer; PRostate cancer Awareness and Initiative for Screening in the European Union
• ISSN: 0302-2838; 1873-7560; 1873-7560
• DOI: 10.1016/j.eururo.2024.04.036

Based on the available evidence, this systematic review indicates that screening programmes have the potential to be cost effective when a risk-based approach and incorporation of magnetic resonance imaging are taken into account. However, determinants of cost effectiveness require further investigation.
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.
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.
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.
This systematic review indicates that screening programmes incorporating a risk-based approach and MRI have the potential to be cost effective.
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.