title: Life expectancy and the value of early detection.
abstract: This paper presents a model of the benefits and costs of early detection of asymptomatic disease as they vary by age. The benefits of early detection tend toward zero as the risk of death from competing causes increases. Costs per detected case also decline with age, assuming that disease incidence rises with age, but are always strictly positive. On balance, there is always an age limit beyond which the costs associated with early detection outweigh the benefits. Application of the model to prostate cancer screening suggests that early detection above age 70 or so is not cost-effective.
authors.affiliation: Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 610, Atlanta, GA 30322, USA. david.howard@emory.edu
authors.forename: David H
authors.initials: DH
authors.lastname: Howard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D042241:Early Diagnosis; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D014481:United States