Health-related quality of life and cost-effectiveness studies in the European randomised study of screening for prostate cancer and the US Prostate, Lung, Colon and Ovary trial

Miller, A B; Madalinska, Joanna B.; Crawford, D.; Essink‐Bot, Marie‐Louise; Goel, Vivek; Koning, Harry J. de; Määttänen, Liisa; Pentikäinen, Tuomo

doi:10.1016/s0959-8049(01)00288-x

Cited by 19 publications

(6 citation statements)

References 30 publications

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“…KEYWORDS: Computed tomography, lung neoplasms, mass screening, quality of life E ffective policy decisions regarding cancer screening programmes require data on the effects of screening on mortality, healthrelated quality of life (HRQoL) and their costeffectiveness [1]. Few studies have examined the HRQoL effects of lung cancer screening with computed tomography (CT) [2][3][4][5].…”

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confidence: 99%

“…The best method to evaluate the long-term impact of screening is to compare a group of screened participants with a control group in a randomised controlled trial (RCT) [1]. The rationale for this is, first, because a study population is often a selective group that is healthier than the general population [6,7] and, secondly, because subjects invited for lung cancer screening differ from the general population in that they are usually heavy current or former smokers.…”

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confidence: 99%

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Long-term effects of lung cancer computed tomography screening on health-related quality of life: the NELSON trial

Bergh¹,

Essink-Bot²,

Borsboom³

et al. 2010

Eur Respir J

105

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The long-term effects of lung cancer computed tomography (CT) screening on health-related quality of life (HRQoL) have not yet been investigated.In the Dutch-Belgian Randomised Lung Cancer Screening Trial (NELSON trial), 1,466 participants received questionnaires before randomisation (T0), 2 months after baseline screening (screen group only; T1) and at 2-yr follow-up (T2). HRQoL was measured as generic HRQoL (12-item shortform questionnaire and EuroQoL questionnaire), anxiety (Spielberger State-Trait Anxiety Inventory) and lung cancer-specific distress (impact of event scale (IES)). Repeated measures of ANOVA were used to analyse differences between the screen and control groups, and between indeterminate (requiring a follow-up CT) and negative screening result groups.At T0 and T2 there were no significant differences in HRQoL scores over time between the screen and control groups, or between the indeterminate or negative second-round screening result group. There was a temporary increase in IES scores after an indeterminate baseline result (T0: mean 4.0 (95% CI 2.8-5.3); T1: mean 7.8 (95% CI 6.5-9.0); T2: mean 4.5 (95% CI 3.3-5.8)).At 2-yr follow-up, the HRQoL of screened subjects was similar to that of control subjects, the unfavourable short-term effects of an indeterminate baseline screening result had resolved and an indeterminate result at the second screening round had no impact on HRQoL.

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confidence: 99%

mentioning

confidence: 99%

Long-term effects of lung cancer computed tomography screening on health-related quality of life: the NELSON trial

Bergh¹,

Essink-Bot²,

Borsboom³

et al. 2010

Eur Respir J

105

View full text Add to dashboard Cite

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“…For example, empirical assessment of the health status effects in the phases of primary treatment and advanced disease within the trial framework would take many years of follow‐up of an immense cohort of screening participants and controls. Instead, the unfavourable effects from primary therapies induced by screening and the favourable effects of preventing advanced prostate cancer can be estimated in samples of non‐trial patients [3].…”

Section: Methods and Resultsmentioning

confidence: 99%

“…Additional primary treatments may cause an increase in life‐years lived by the patients with the side‐effects of radical prostatectomy, external beam radiotherapy and alternative primary treatment options, including watchful waiting. However, provided there is a decrease in prostate cancer mortality as a result of prostate cancer screening, favourable health status effects occur from the associated decrease in the incidence of end‐stage prostate cancer [3].…”

Section: Introductionmentioning

confidence: 99%

Including the quality‐of‐life effects in the evaluation of prostate cancer screening: expert opinions revisited?

2003

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OBJECTIVE To apply the general empirical framework for estimating utilities in cost‐utility analysis (CUA) of population‐based prostate cancer screening, including an assessment of empirical health status with a classifying measure (e.g. the EQ‐5D) and linking these descriptions to utility estimates using the standard preference‐based algorithm, combining them with the appropriate duration into quality‐adjusted life years, and sensitivity analysis. MATERIALS AND METHODS Empirical studies to describe and value the health status effects of prostate cancer screening have been ongoing within the Rotterdam centre of the European Randomised Study on Screening for Prostate Cancer since 1995. The results of these studies, including the screening, the primary treatment phase and advanced disease, will be used in estimating utilities for cost‐utility analysis. RESULTS Estimation of cost‐utility of population‐based prostate cancer screening with the results of the three empirical health status studies yielded partly counterintuitive results, underestimating the unfavourable health status effects that are inevitably associated with prostate cancer screening. This may be caused by other than health effects of the screening itself (‘process effects’) and adaptive changes in perception of their situation in patients after curative primary treatment (‘response shift’), among other elements. CONCLUSION These results prompted us to reconsider the suitability of the general framework of CUA for screening programmes. Possible directions for solutions are indicated.

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“…The Finnish trial is the largest component in the ERSPC [5]. The main outcome of the ERSCP study is prostate cancer mortality rate, with health-related quality of life (HRQL) and cost-effectiveness as secondary endpoints [6].…”

Section: Introductionmentioning

confidence: 99%

Why do men opt out of prostate‐cancer screening? Attitudes and perception among participants and non‐participants of a screening trial

et al. 2010

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Study Type – Decision analysis (patient preference) Level of Evidence 4 OBJECTIVE To evaluate attitudes to prostate cancer screening with prostate‐specific antigen (PSA) of men who complied with offered screening and those who declined it within the Finnish randomized population‐based screening trial, and to compare general health‐related quality of life (HRQL) between participants and non‐participants. SUBJECTS AND METHODS Self‐administered questionnaires were sent to 500 men randomized into the screening arm in 1996–99 within the Finnish component of the European Randomized Study on Screening for Prostate Cancer. A similar survey was conducted among 500 non‐participants. RESULTS Response proportions among the screening participants and non‐participants were 59% and 28%, respectively. Current smoking was less frequent (P < 0.05) among the participants. In terms of attitude, the participants regarded the prostate cancer study as more important and the invitation letter as more informative than the non‐participants (P < 0.001). There was no clear difference in worry about treatment consequences. The most commonly given reasons for not participating included previous PSA testing (41%), forgetting the invitation (51%), or not wanting to think of prostate cancer (39%) and regarding possible further diagnostic examinations as unpleasant (28%). The non‐participants had a lower mental health score (P < 0.001) than the participants in the RAND‐36 Survey. CONCLUSION Most men who chose not to attend screening had a positive attitude, but did not participate due to practical reasons. However, two‐thirds of the non‐participants indicated a willingness to participate in the next screening round.

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Health-related quality of life and cost-effectiveness studies in the European randomised study of screening for prostate cancer and the US Prostate, Lung, Colon and Ovary trial

Cited by 19 publications

References 30 publications

Long-term effects of lung cancer computed tomography screening on health-related quality of life: the NELSON trial

Long-term effects of lung cancer computed tomography screening on health-related quality of life: the NELSON trial

Including the quality‐of‐life effects in the evaluation of prostate cancer screening: expert opinions revisited?

Why do men opt out of prostate‐cancer screening? Attitudes and perception among participants and non‐participants of a screening trial

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