Thompson I M, Optenberg S A
Urology Service Brooke Army Medical Center, Center for Health Care Studies, US Army Medical Department Center and School, San Antonio, Texas, USA.
Oncology (Williston Park). 1995 Nov;9(11 Suppl):141-5.
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.
由于前列腺癌的高发病率，以及通过筛查发现的许多肿瘤并不会导致发病或死亡，因而无需治疗，所以前列腺癌筛查的价值仍然存在争议。美国国立癌症研究所（NCI）正在进行的一项筛查试验最终可能会结束这场争论。然而，与此同时，成本效益估计表明，前列腺癌筛查和治疗每获得一个粗略的和质量调整生命年的成本在8400美元至23100美元之间（筛查和治疗估计可获得1至2.68个质量调整生命年），而且这些估计实际上低于许多普遍接受的医疗干预措施的成本，或者处于其成本范围内，包括对50岁以下女性进行乳房X线筛查（232000美元）以及用卡托普利（82600美元）或氢氯噻嗪（23500美元）治疗高血压。因此，我们得出结论，前列腺癌筛查确实可能具有成本效益，应该提供给处于高危年龄范围的男性。
