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In the U.S., rates of prostate cancer screening using the prostate-specific antigen (PSA) test have declined in recent years, but many patients still are screened. In this sophisticated microsimulation model, researchers used information from screening trials and epidemiological databases to estimate the cost-effectiveness of various screening and treatment pathways. A cost per quality-adjusted life-year (QALY) lower than US$100,000 was used as a threshold for cost-effectiveness.
PSA-based screening in men between the ages of 55 and 69 might be cost-effective if:
screening is conducted every 4 years, rather than annually.
men with low-risk cancer discovered by biopsy undergo active surveillance, rather than immediate surgery or radiotherapy.
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