A cost-benefit analysis for sonographic screening for renal tumors.

Abstract

665 Background: In the last 2 decades, the rates of metastatic Renal Cell Carcinoma (RCC) at diagnosis declined from 33% to 17%This fact is attributed to massive penetration of cross sectional imaging leading to a marked stage migration. The cost of targeted therapy for metastatic RCC patients is very high. These trends led us to hypothesize that screening for RCC with ultrasound may be cost effective. Objective: To assess the cost effectiveness of screening with ultrasound for renal tumors in the general population over 60 years of age. Methods: Using the Markov model, a mathematical framework was set up describing the course of disease with and without screening for RCC using abdominal ultrasonography. Quality Adjusted Life Year (QALY) and financial costs were the outputs of the model. Results: Average costs for the screening strategy was 137.4 U$ and for non-screening was 31.4 U$. Screening and non-screening strategy would add an average of 21.7396 and 21.7385 QALY, respectively. An increase of 0.001 QALY equates to Incremental Cost Effectiveness Ratio (ICER) of 86,4 U$ per QALY, Currently, the cost which is considered cost effective for 1 QALY point is approximately 27,548.21 U$. The two variables most influential on the model output were prevalence of RCC and US cost. Conclusions: To our knowledge, this is the sole cost benefit screening study performed for RCC in the targeted therapy era. Screening for renal tumors using abdominal ultrasonography at a cost of 35.81 U$ per exam is cost effective. Our findings are highly suggestive that early screening for RCC may be cost effective for preventing RCC metastatic disease and nevertheless will save lives.

Screening for renal cell carcinoma in renal transplant recipients: a single-centre retrospective study

“…However, two recent studies have shown otherwise. Using the Markov model, Roizman et al proposed that screening for RCC in the general population using ultrasonography could be a cost-effective option 23. Another study used a similar model and suggested that RCC screening in the general population may be cost-effective in males.…”

“…Using the Markov model, Roizman et al proposed that screening for RCC in the general population using ultrasonography could be a cost-effective option. 23 Another study used a similar model and suggested that RCC screening in the general population may be cost-effective in males. This costeffectiveness was not demonstrated in females due to a lower prevalence of RCC.…”