The Economics of Active Surveillance for Prostate Cancer

Abstract

Prostate cancer remains the number 1 cancer diagnosis in North American men and is the second most commonly diagnosed cancer worldwide. As PSA use rises worldwide, global prostate cancer incidence is expected to increase. With widely disparate and escalating costs for prostate cancer care, relatively few studies compare the cost-effectiveness of commonly offered treatment modalities for localized disease, including active surveillance. With the escalating cost projections for prostate cancer management, it is critical to examine the economics of active surveillance compared with other therapies.This chapter aims to better understand the health care expenditures associated with active surveillance for early prostate cancer. The medical literature was searched for articles describing direct or indirect costs associated with prostate cancer care with particular attention to active surveillance. Multiple variables are taken into account including frequency of office visits, surveillance testing, and receipt of delayed secondary treatments over time.Prostate cancer care worldwide can incur substantial costs over time. More expensive therapy does not necessarily equate with better outcomes, and comparative effectiveness research aims to define the most cost-effective care for a given health-related outcomes. As we continue to refine prostate cancer treatment for all stages of disease, data on the economy of active surveillance are crucial to determining the optimal management for early, low-risk disease.KeywordsProstate CancerRadical ProstatectomyAndrogen Deprivation TherapyActive SurveillanceProstate BiopsyThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.