title: The economics of active surveillance for prostate cancer.
abstract: OBJECTIVE
  To review the economics of managing low-risk prostate cancer with active surveillance compared with other standard therapies.
  
  
  RESULTS
  The expenses of caring for men with prostate cancer vary depending on treatment modality chosen and appear to be escalating. Costs are generally lowest with traditional watchful waiting and highest with radiation therapy. Compared with immediate treatment, active surveillance can result in a net per-patient savings of $12194 at 5 years and $4329 at 10 years. Active surveillance demonstrates lower 5-year costs over other initial treatments as long as fewer than 70% exit active surveillance in any given year and at least 12% of men remain on active surveillance at year 5. Yearly surveillance biopsy reduces the average simulated cost savings at 10 years by $4951 per patient.
  
  
  CONCLUSIONS
  Active surveillance represents a cost-effective strategy for managing low-risk prostate cancer, as the majority of men remain without additional treatment over time. Prostate biopsy is the highest expenditure associated with active surveillance, and increasing the frequency of prostate biopsy will reduce the cost-effectiveness of this approach.
authors: Department of Urology, University of California, Sacramento, CA 95817, USA. marc.dallera@ucdmc.ucdavis.edu
authors: Marc A
authors: MA
authors: Dall'Era
mesh_terms: D001706:Biopsy / Q000191:economics; D003198:Computer Simulation; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D018588:Fee-for-Service Plans; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008390:Markov Chains; D018803:Models, Economic; D018579:Patient Selection; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D057832:Watchful Waiting / Q000191:economics*