Prostate cancer screening: evaluation of clinical and economic effectiveness

Economical efficacy of the prostate cancer screening in the Russian Federation was estimated using the modeling of three healthcare systems based on the official statistical data and the modern evidence from the major publications. Three following models of healthcare were selected for analysis: 1) absence of prostate cancer screening; 2) total screening of prostate cancer with the use of prostate/specific antigen (PSA); 3) selective prostate cancer screening (without total use of PSA) - detection of the men at the high risk of the prostate cancer using the questionnaires and their further evaluation. Efficacy of these approaches was estimated as for the costs of 1 year of saved life in a patient with prostate cancer. Our results show that the most effective according to the mentioned criterion was the variant of selective screening, where the costs for one year of life of the ill patients were 9832 rubles. For total screening the costs were 10470 rubles, for the absence of screening - 47680 rubles. Moreover it was shown that selective screening could led to the decrease in the identification of clinically insignificant prostate cancer and therefore 2-times lower absolute costs in comparison with total screening. The results obtained point at the perspectivity of the wide of the selective prostate cancer screening.