Table 4.
Modelling results for a hypothetical cohort of 1000 patients referred for elevated PSA using different strategies for cancer detection. In brackets are projected reductions compared to the base model (* compared to MRI + biopsy all)
| Pathway | ||||||
|---|---|---|---|---|---|---|
| MRI + biopsy all | MRI all + biopsy if M3–5 | MRI all + biopsy if M3–5 or PSAd ≥ 0.15 | MRI all + biopsy if M3–5 or PSAd ≥ 0.10 | MRI + biopsy only ifphi ≥ 25 | MRI + biopsy only ifphi ≥ 30 | |
| No. of MRI scans (% lower*) | 1000 | 1000 (0%) | 1000 (0%) | 1000 (0%) | 850 (−15%) | 750 (−25%) |
| No. of biopsies needed (% lower*) | 1000 | 772 (−23%) | 884 (−12%) | 941 (−6%) | 850 (−15%) | 750 (−25%) |
| Detection of ≥ GG2 cancers | ||||||
| Cancers identified (% lower*) | 100% | 91% (−9%) | 98% (−2%) | 99% (−1%) | 96% (−4%) | 92% (−8%) |
| Unnecessary biopsies (% lower*) | 527 | 343 (−35%) | 420 (−20%) | 471 (−11%) | 396 (−25%) | 314 (−40%) |
| Detection of ≥ CPG3 cancers | ||||||
| Cancers identified (% lower*) | 100% | 95% (−5%) | 100% (0%) | 100% (0%) | 99% (−1%) | 95% (−5%) |
| Unnecessary biopsies (% lower*) | 677 | 466 (−31%) | 562 (−17%) | 618 (−9%) | 529 (−21%) | 442 (−35%) |
| Cost analysis | ||||||
| Cost/pt. (% lower*) | £965 | £796 (−18%) | £879 (−9%) | £921 (−5%) | £869 (−10%) | £774 (−20%) |