Table 1.
Study characteristics
| Study | Setting | Population | Strategies compared | PSA threshold | Treatment | Outcome measure |
|---|---|---|---|---|---|---|
| Chilcott et al. [23] | UK | Men aged 50–74 | · single screen at 50 · screen every 4 years from 50 to 74 years · screen every 2 years 50–74 years · screen every year from 50 to 74 · screen at 50, 60, 65, 70 · screen every 4 years 50–70, 55–74, 55–70 · screen every 2 years 50–70, 55–74, 55–70 |
3.0 ng/ml 3.0 ng/ml 3.0 ng/ml 3.0 ng/ml 3.0 ng/ml 3.0 ng/ml 3.0 ng/ml |
· prostatectomy with ADT · radiotherapy with ADT · prostatectomy without ADT · radiotherapy without ADT · watchful waiting · active monitoring |
Cost per QALY gained |
| Heijnsdijk et al. [25] | NR | Men aged 55–75 | 68 scenarios: | 3.0 ng/ml | · radiotherapy | Cost per QALY gained |
| · starting at age 55; screen intervals at 1, 2, 3, 4, 6, 8, 10, 12, 14 years | 3.0 ng/ml | · prostatectomy | ||||
| · once in a lifetime | 3.0 ng/ml | · active surveillance | ||||
| · age at stopping was varied 55–75 years | 3.0 ng/ml | · metastases: palliative care | ||||
| Hummel and Chilcott [24] | UK | Men aged 50–74 | · single screen at 50: | 3.0 ng/ml | · radiotherapy (with and without hormone therapy) | Cost per QALY gained |
| · screen every 4 years from 50 to 74 years | 3.0 ng/ml | · prostatectomy (with and without hormone therapy) | ||||
| · screen every 2 years 50–74 years | 3.0 ng/ml | · watchful waiting | ||||
| · screen every year from 50 to 74 years | 3.0 ng/ml | · active monitoring | ||||
| Keller et al. [29] | Australia | Men aged 50–69 | · opportunistic screening (current practice) · screen every 2 years from 50 to 69 years |
3.0 ng/ml to 2.5 ng/mla | · prostatectomy · radiotherapy · active surveillance |
Cost per QALY gained |
| 3.0 ng/ml to 2.5 ng/mla | · watchful waiting One strategy with immediate treatment and one delayed based on Gleason score |
Cost per life year gained | ||||
| Kobayashi et al. [27] | NR | Men aged 50–70 | · annual screen irrespective of baseline | N/A | no details on exact nature of treatments | Cost per QALY gained |
| · baseline PSA ≤ 1.0 ng/ml biennial rescreening | 1.0 ng/ml | |||||
| · baseline PSA ≤ 2.0 ng/ml biennial rescreening | 2.0 ng/ml | |||||
| · baseline PSA ≤ 3.0 ng/ml biennial rescreening | 3.0 ng/ml | |||||
| · baseline PSA ≤ 4.0 ng/ml biennial rescreening | 4.0 ng/ml | |||||
| Martin et al. [30] | Australia | Men aged 50- (unclear) | · average risk: screen every 4 years | 4.0 ng/ml | · radiotherapy (with and without hormone therapy) | Cost per QALY gained |
| · high risk: screen every 4 years | 4.0 ng/ml | · prostatectomy (with and without hormone therapy) | ||||
| · very high risk: screen every 4 years | 4.0 ng/ml | · conservative management | ||||
| Pataky et al. [26] | Canada | Men aged 40–74 | 14 scenarios: | · radiotherapy (with and without hormone therapy) | Cost per QALY gained and | |
| · Screen at 50, 60, 70 | 3.0 ng/ml | · prostatectomy (with and without hormone therapy) | ||||
| · Screen at 60 followed by screen at 65 | 3.0 ng/ml | · conservative management | Cost per life year gained | |||
| · screen every 4 years 55–69, 50–74 | 3.0 ng/ml | |||||
| · screen every 4 years 50–74 | 3.0 ng/ml, (4.0 ng/ml for ≥70 years old) | |||||
| · screen every 2 years 60–74, 50–69, 55–74, 50–74, 40–74 | 3.0 ng/ml | |||||
| · screen every 2 years 50–74 | 3.0 ng/ml, (4.0 ng/ml for ≥70 years old) | |||||
| · adaptive screen 50–74 | 3.0 ng/ml | |||||
| Roth et al. [28] | US | Men aged 45–69 | 18 scenarios: | (1) all cases receive curative surgery, radiotherapy with or without adjuvant hormone therapy, | Cost per QALY gained and | |
| · screen yearly 45–69, 50–74, 55–69 | 4.0 ng/ml | (2) Gleason < 7, <T2a receive conservative treatment or curative treatment, all others as above | ||||
| · screen yearly 45–69, 50–74, 55–69 | 10.0 ng/ml | |||||
| · screen yearly if >3.0 ng/ml, every 2 years otherwise,45–69 | 3.0 ng/ml | Cost per life year gained | ||||
| · screen yearly if >3.0 ng/ml, every 2 years otherwise,45–69 | 10.0 ng/ml | |||||
| · screen every 4 years 50–74 | 4.0 ng/ml | |||||
| · screen every 4 years 50–74, 55–69 | 10.0 ng/ml | |||||
| · screen every 2 years if >1.0 ng/ml, every 4 years otherwise, 50–74 | 4.0 ng/ml | |||||
| · screen every 2 years if >1.0 ng/ml, every 4 years otherwise, 50–74 | 10.0 ng/ml | |||||
| · screen yearly with age dependent threshold, 50–74 | 3.5(50–59), 4.5(60–69), 6.5(70–74) | |||||
| · screen yearly with age dependent threshold 50–74 | 4.5(50–59), 5.5(60–69), 8.5(70–74) | |||||
| · screen every 2 years 55–69 | 3.0 ng/ml | |||||
| · screen every 4 years 55–69 | 3.0 ng/ml | |||||
| · screen every 2 years 55–69 | 10.0 ng/ml | |||||
| Wolstenholme et al. [31] | UK | Men aged 50–65 | · single screen at 50, 55, 60 and 65 | 3.0 ng/ml | active surveillance, prostatectomy, radiotherapy, orchidectomy, hormonal therapy, chemotherapy | Cost per life year saved/gained |
| · screen every 5 years 50–65 | 3.0 ng/ml | |||||
| Shteynshlyuger & Andriole, [22] | Europe | Men aged 60–70 | · “PSA screening reported in ERSPC”: | · Not reported. Assumed follows ERSPC trial | Cost per life year saved | |
| · screen every 4 years | 3.0 ng/ml or 4.0 ng/ml (depending on the centre) | |||||
| · no such screening | 3.0 ng/ml or 4.0 ng/ml (depending on the centre) |
a The study is based on the Goteburg centre of the ERSPC trial, which altered the PSA threshold overtime to reflect current recommendations. ADT androgen deprivation therapy