[Screening of cancer of the prostate (IV). Economic approach: the costs of screening tests and treatment. Members of the Sub-Committee of the Prostate of CCAFU].
OBJECTIVE
To estimate the unit and global costs of prostatic cancer screening and the resulting treatments, based on a theoretical screening protocol and the epidemiological data available in France.


METHODS
The screening protocol consisted of digital rectal examination (DRE) performed by the general practitioner and serum prostate specific antigen (PSA) assay, with confirmation of the diagnosis by systematized ultrasound-guided biopsies performed by a specialist. Costs were calculated on the basis of the French National Health rating. Treatment costs were estimated on the basis of real public and private establishment case files. Extrapolations to the general population were based on two estimations of the screening yield.


RESULTS
The theoretical cost of screening was estimated to be 501 French Francs (FF) per person screened and 16,700 or 91,000 FF per cancer detected, depending on the detection rate adopted. The mean cost of curative treatment was estimated to be 44,000 FF per cancer. The theoretical global cost of screening and treatment was estimated to be between 4 and more than 10 billion French Francs.


CONCLUSIONS
Unit costs per individual of screening and treatment of prostatic cancer may appear acceptable. The biases of economic calculations related to extrapolations to the general population and uncertainties concerning the public health benefits of organized screening compared to the current situation of individual screening explain the current predominant attitude of non-recommendation of organized screening.
Haillot
O
O
Service d'Urologie, CHU Bretonneau, Tours, France.
Villers
A
A
Soulie
M
M
Baron
J C
JC
D000368:Aged; D003365:Costs and Cost Analysis; D005602:France; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D011468:Prostatectomy / Q000191:economics; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D011878:Radiotherapy / Q000191:economics
Dépistage du cancer de la prostate (IV). Approche économique: les coûts des tests de dépistage et des traitements. Membres du sous-comité Cancer de Prostate du CCAFU.