Early prostate cancer: diagnostic costs of screening transrectal US and digital rectal examination.

Abstract

A screening study with transrectal ultrasound (US) and digital rectal examination to diagnose early prostate cancer was performed to calculate diagnostic costs. The total costs of screening 784 men were $130,400 with transrectal US and $41,080 with digital rectal examination. Per diagnosed cancer, the costs were $6,520 for transrectal US and $4,108 for digital rectal examination, a difference of 37%. The costs per early diagnosed cancer (stage A or B) were $7,671 and $5,869 for transrectal US and digital rectal examination, respectively--a difference of 23%. The costs per early cancer that would have been advanced if diagnosed without screening were $22,177 for transrectal US and $28,528 for digital rectal examination--a difference of 22% in favor of transrectal US. Equations for these relative costs were generated for transrectal US and digital rectal examination. Costs are related to changes in prevalences and to changes in the stages of prostate cancer when diagnosed without screening.

Diagnosis, management and screening of early localised prostate cancer.

“…Empirical and modelling studies have produced a number of estimates of the costs associated with various forms of screening for prostate cancer. 31,[381][382][383][384] These are shown in Tables 29 and 30, with Table 29 showing those studies which include the costs associated with screening, but not with subsequent treatment. Table 30 shows those studies which have incorporated the cost of treatment in their estimates.…”

“…Others have used a restricted notion of costs (e.g. Torp-Pedersen and colleagues' study estimates costs on the basis of user charges for diagnostic tests alone 383 ).…”

The State of Prostate Cancer Screening in the United States

“…Several well-conducted studies have investigated the role of TRUS in early detection [74][75][76][77][78][79], Waterhouse and Resnick [80] report that ultrasound has a sensitivity of 71-92 % for prostate carcinoma and 60-85 % for subclinical disease, specificity 41-79%, positive predictive value 30%. The sensitivity and positive predictive value appear to be better than in rectal examination, however, the low specificity, the invasiveness of the procedure and the cost of testing preclude routine screening use.…”

Diagnosis of prostate cancer via nanotechnological approach

“…Currently available clinical diagnostic methods for prostate cancer include biochemical assay, [12][13][14][15][16][17][18][19][20] biopsy, [21][22][23][24][25][26][27] digital rectal examination (DRE), [28][29][30][31][32] and transrectal ultrasonography [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] as described in Figure 2. Among these methods, the biochemical assay is used for initial screening.…”

“…However, DRE is not useful for the early detection of prostate tumor because of a possibility that a tumor could originate from the ventral or other untouchable sides of the gland. [28][29][30][31][32] In addition to the poor sensitivity of the examination, it is an unpleasant procedure for a patient to undergo.…”