Skip to main content
SpringerLink
Log in

The Economic Costs of Early Stage Prostate Cancer

  • Review Article
  • Published:
PharmacoEconomics Aims and scope Submit manuscript

Abstract

The economic costs of early stage prostate cancer are significant, and will likely increase as the proportion of older men grows in the population of industrialised nations. In the US, total costs have been estimated to range from $US1.72 billion to $US4.75 billion annually (1990 costs). Costs related to early stage prostate cancer arise from screening, staging and treatment. Cost-effectiveness models of population-based prostate cancer screening indicate that such screening could result in as much as $US27.9 billion (1988 values) in charges to the US healthcare system. Evidence-based cancer-staging strategies would result in significant reduction of wasted expense.

Rational allocation of healthcare dollars for prostate cancer screening and treatment may ultimately depend on data from randomised controlled trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I

Similar content being viewed by others

Notes

  1. The Gleason score is a measure of tumor aggressiveness. It is determined via microscopic evaluation of the specimen by a pathologist.

References

  1. Frezza EE, Girnys RP, Silich RJ, et al. Commentary: quality of care and cost containment are the hospital-based ambulatory surgery challenges for the future. Am J Med Qual 2000; 15 (3): 114–8

    Article  PubMed  CAS  Google Scholar 

  2. Savage GT, Campbell KS, Patman T, et al. Beyond managed costs. Health Care Manage Rev 2000; 25 (1): 93–108

    Article  PubMed  CAS  Google Scholar 

  3. Szucs T. The growing importance of cost-effectiveness in oncologic practice. Curr Opin Oncol 1998; 10 (4): 279–83

    Article  PubMed  CAS  Google Scholar 

  4. Stanford JSRA, Coyle LM, Cerhan J, et al. Prostate cancer trends, 1973–1995. Bethesda (MD): National Cancer Institute, 1999. Report no. 99-4543

    Google Scholar 

  5. Brown ML. The economic burden of cancer. New York: Marcel Dekker, Inc, 1995

    Google Scholar 

  6. Optenberg S, Thompson IM. Economics of screening for carcinoma of the prostate. Urol Clin North Am 1990; 17 (4): 719–35

    PubMed  CAS  Google Scholar 

  7. Grover SA, Coupal L, Zowall H, et al. The economic burden of prostate cancer in Canada: forecasts from the Montreal Prostate Cancer Model [see comments]. CMAJ 2000; 162 (7): 987–92

    PubMed  CAS  Google Scholar 

  8. Henriksson P, Edhag O. Cost-effectiveness comparison of estrogen therapy and orchidectomy in patients with prostatic cancer. Int J Tech Assess Health Care 1987; 3: 523

    Article  CAS  Google Scholar 

  9. Carlsson P, Hjertberg H, Jonsson B, et al. The cost of prostate cancer in a defined population. Scand J Urol Nephrol 1989; 23: 93

    Article  PubMed  CAS  Google Scholar 

  10. Borre M, Nerstrøm B, Overgaard J. The dilemma of prostate cancer–a growing human and economic burden irrespective of treatment strategies. Acta Oncol 1997; 36 (7): 681–7

    Article  PubMed  CAS  Google Scholar 

  11. Salo J, Rannikko S, Makinen J, et al. Echogenic structure of prostatic cancer imaged on radical prostatectomy specimens. Prostate 1987; 10 (1): 1–9

    Article  PubMed  CAS  Google Scholar 

  12. Littrup P, Lee F, Mettlin CJ. Prostate cancer screening current trends and future implications. CA Cancer J Clin 1992; 42 (4): 198–211

    Article  PubMed  CAS  Google Scholar 

  13. Friedman GD, Hiatt RA, Quesenberry CP, et al. Case control study of screening for prostate cancer by digital rectal examinations. Lancet 1991 Sept 28; 338 (8770): 819

    Google Scholar 

  14. Littrup P, Goodman AC, Mettlin CJ. The benefit and cost of prostate cancer early detection. The Investigators of the American Cancer Society-National Prostate Cancer Detection Project. CA Cancer J Clin 1993; 43 (3): 134–49

    Article  PubMed  CAS  Google Scholar 

  15. Agency for Healthcare Research and Quality. Guide to USPSTF clinical preventative services. 2nd ed. Rockville (MD): Agency for Healthcare Research and Quality, 1996

    Google Scholar 

  16. Prostate cancer treatment summary statement. Physicians data query [database]. Bethesda (MD): National Cancer Institute, 2002

  17. Burack RC, Wood Jr DP. Screening for prostate cancer. The challenge of promoting informed decision making in the absence of definitive evidence of effectiveness. Med Clin North Am 1999; 83 (6): 1423–42

    Article  PubMed  CAS  Google Scholar 

  18. Goluboff E, Olsson CA. Urologists on a tightrope: coping with a changing economy. J Urol 1994; 151: 1–4

    PubMed  CAS  Google Scholar 

  19. Neal DE, Leung HY, Powell PH, et al. Unanswered questions in screening for prostate cancer. Eur J Cancer 2000; 36 (10): 1316–21

    Article  PubMed  CAS  Google Scholar 

  20. Kramer BS, Brown ML, Prorok PC, et al. Prostate cancer screening: what we know and what we need to know [see comments]. Ann Intern Med 1993; 119 (9): 914–23

    PubMed  CAS  Google Scholar 

  21. Handley MR, Stuart ME. The use of prostate specific antigen for prostate cancer screening: a managed care perspective. J Urol 1994; 152: 1689–92

    PubMed  CAS  Google Scholar 

  22. Carlsson PPKV, Varenhorst E. Costs and benefits of early detection of prostatic cancer. Health Policy 1990; 16 (3): 241–53

    Article  PubMed  CAS  Google Scholar 

  23. Benoit RM, Naslund MJ. The economics of prostate cancer screening. Oncology 1997; 11 (10): 1533–43

    PubMed  CAS  Google Scholar 

  24. Levran Z, Gonzalez JA, Diokno AC, et al. Are pelvic computed tomography, bone scan and pelvic lymphadenectomy necessary in the staging of prostatic cancer? Br J Urol 1995; 75 (6): 778–81

    Article  PubMed  CAS  Google Scholar 

  25. Huncharek M, Muscat J. Serum prostate-specific antigen as a predictor of radiographic staging studies in newly diagnosed prostate cancer. Cancer Invest 1995; 13 (1): 31–5

    Article  PubMed  CAS  Google Scholar 

  26. Flanigan RC, McKay TC, Olson M, et al. Limited efficacy of preoperative computed tomographic scanning for the evaluation of lymph node metastasis in patients before radical prostatectomy. Urology 1996; 48 (3): 428–32

    Article  PubMed  CAS  Google Scholar 

  27. O’Dowd GJ, Veltri RW, Orozco R, et al. Update on the appropriate staging evaluation for newly diagnosed prostate cancer. J Urol 1997; 158 (3 Pt 1): 687–98

    Article  PubMed  Google Scholar 

  28. Haukaas S, Roervik J, Halvorsen OJ, et al. When is bone scintigraphy necessary in the assessment of newly diagnosed, untreated prostate cancer? Br J Urol 1997; 79 (5): 770–6

    Article  PubMed  CAS  Google Scholar 

  29. Albertsen PC, Hanley JA, Harlan LC, et al. The positive yield of imaging studies in the evaluation of men with newly diagnosed prostate cancer: a population based analysis. J Urol 2000; 163 (4): 1138–43

    Article  PubMed  CAS  Google Scholar 

  30. Oesterling J. Using PSA to eliminate the staging radionuclide bone scan. Urol Clin North Am 1993; 20 (4): 705–11

    PubMed  CAS  Google Scholar 

  31. Danella J, deKernion JB, Smith RB, et al. The contemporary incidence of lymph node metastases in prostate cancer: implications for laparoscopic lymph node dissection. J Urol 1993; 149 (6): 1488–91

    PubMed  CAS  Google Scholar 

  32. Bluestein D, Bostwick DG, Bergstalh EJ, et al. Eliminating the need for bilateral pelvic lymphadenectomy in select patients with prostate cancer. J Urol 1994; 151: 1315–20

    PubMed  CAS  Google Scholar 

  33. Oesterling JE. Using prostate-specific antigen to eliminate unnecessary diagnostic tests: significant worldwide economic implications. Urology 1995; 46 (3 Suppl A): 26–33

    Article  PubMed  CAS  Google Scholar 

  34. Campbell SC, Klein EA, Levin HS, et al. Open pelvic lymph node dissection for prostate cancer: a reassessment. Urology 1995; 46 (3): 352–5

    Article  PubMed  CAS  Google Scholar 

  35. Wilt TJ, Brawer MK. The Prostate Cancer Intervention Versus Observation Trial (PIVOT). Oncology (Huntingt) 1997; 11 (8): 1133–9, 1139–4

    CAS  Google Scholar 

  36. Greenwald H, Henke CJ. HMO membership, treatment, and mortality risk among prostatic cancer patients. Am J Public Health 1992; 82: 1099

    Article  PubMed  CAS  Google Scholar 

  37. Penson DF, Schonfeld WH, Flanders SC, et al. Relationship of first-year costs of treating localized prostate cancer to initial choice of therapy and stage at diagnosis: results from the CAPSURE database. Urology 2001; 57 (3): 499–503

    Article  PubMed  CAS  Google Scholar 

  38. Taplin SH, Barlow W, Urban N. Stage, age, comorbidity, and direct costs of colon, prostate, and breast cancer care. J Natl Cancer Inst 1995; 87 (6): 417–26

    Article  PubMed  CAS  Google Scholar 

  39. Brasso K, Friis S, Juel K, et al. The need for hospital care of patients with clinically localized prostate cancer managed by noncurative intent: a population based registry study. J Urol 2000; 163 (4): 1150–4

    Article  PubMed  CAS  Google Scholar 

  40. Wagner III TT, Young D, Bahnson RR. Charge and length of hospital stay analysis of radical retropubic prostatectomy and transperineal prostate brachytherapy. J Urol 1999; 161 (4): 1216–8

    Article  PubMed  Google Scholar 

  41. Ellis W. Comparative single institution costs of radical retropubic prostatectomy, prostate seed implantation, and prostate seed implantation with external beam radiotherapy. J Urol 1999; 161: 154

    Article  Google Scholar 

  42. Optenberg S, Thompson IM. Comparative analysis of total perioperative charges of radical prostatectomy and brachytherapy. J Urol 1999; 161: 11

    Article  Google Scholar 

  43. Brandeis J, Pashos CL, Henning JM, et al. A nationwide charge comparison of the principal treatments for early stage prostate cancer. Cancer 2000; 89 (8): 1792–9

    Article  PubMed  CAS  Google Scholar 

  44. Ciezki JP, Klein EA, Angermeier KW, et al. Cost comparison of radical prostatectomy and transperineal brachytherapy for localized prostate cancer. Urology 2000; 55 (1): 68–72

    Article  PubMed  CAS  Google Scholar 

  45. Hanks GE, Hanlon AL, Schultheiss TE, et al. Dose escalation with 3D conformal treatment: five year outcomes, treatment optimization, and future directions. Int J Radiat Oncol Biol Phys 1998; 41 (3): 501–10

    Article  PubMed  CAS  Google Scholar 

  46. Fukunaga-Johnson N, Sandler HM, McLaughlin PW, et al. Results of 3D conformal radiotherapy in the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys 1997; 38 (2): 311–7

    Article  PubMed  CAS  Google Scholar 

  47. Zelefsky MJ, Leibel SA, Gaudin PB, et al. Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer [see comments]. Int J Radiat Oncol Biol Phys 1998; 41 (3): 491–500

    Article  PubMed  CAS  Google Scholar 

  48. Perez CA, Purdy JA, Harms W, et al. Three-dimensional treatment planning and conformal radiation therapy: preliminary evaluation. Radiother Oncol 1995; 36 (1): 32–43

    Article  PubMed  CAS  Google Scholar 

  49. Kobeissi BJ, Gupta M, Perez CA, et al. Physician resource utilization in radiation oncology: a model based on management of carcinoma of the prostate. Int J Radiat Oncol Biol Phys 1998; 40 (3): 593–603

    Article  PubMed  CAS  Google Scholar 

  50. Horwitz EM, Hanlon AL, Pinover WH, et al. The cost effectiveness of 3D conformal radiation therapy compared with conventional techniques for patients with clinically localized prostate cancer [see comments]. Int J Radiat Oncol Biol Phys 1999; 45 (5): 1219–25

    Article  PubMed  CAS  Google Scholar 

  51. Denis LJ. The role of active treatment in early prostate cancer. Radiother Oncol 2000; 57 (3): 251–8

    Article  PubMed  CAS  Google Scholar 

  52. Gee WF, Holtgrewe HL, Albertsen PC, et al. Practice trends in the diagnosis and management of prostate cancer in the United States. J Urol 1995; 154 (1): 207–8

    Article  PubMed  CAS  Google Scholar 

  53. Litwin MS, Pasta DJ, Stoddard ML, et al. Epidemiological trends and financial outcomes in radical prostatectomy among Medicare beneficiaries, 1991 to 1993 [published erratum appears in J Urol 1998 Dec; 160 (6 Pt 1): 2164]. J Urol 1998; 160 (2): 445–8

    Article  PubMed  CAS  Google Scholar 

  54. Lu-Yao GL, Greenberg ER. Changes in prostate cancer incidence and treatment in USA. Lancet 1994; 343 (8892): 251–4

    Article  PubMed  CAS  Google Scholar 

  55. Litwin MS, Smith RB, Thind A, et al. Cost-efficient radical prostatectomy with a clinical care path [see comments]. J Urol 1996; 155 (3): 989–93

    Article  PubMed  CAS  Google Scholar 

  56. Litwin MS, Shpall AI, Dorey F. Patient satisfaction with short stays for radical prostatectomy. Urology 1997; 49 (6): 898–905, 905–6

    Article  PubMed  CAS  Google Scholar 

  57. Klein EA, Grass JA, Calabrese DA, et al. Maintaining quality of care and patient satisfaction with radical prostatectomy in the era of cost containment. Urology 1996; 48 (2): 269–76

    Article  PubMed  CAS  Google Scholar 

  58. Palmer JS, Worwag EM, Conrad WG, et al. Same day surgery for radical retropubic prostatectomy: is it an attainable goal? [see comments]. Urology 1996; 47 (1): 23–8

    Article  PubMed  CAS  Google Scholar 

  59. Goh M, Kleer CG, Kielczewski P, et al. Autologous blood donation prior to anatomical radical retropubic prostatectomy: is it necessary? Urology 1997; 49 (4): 569–73, 574

    Article  PubMed  CAS  Google Scholar 

  60. Guillonneau B, Rozet F, Barret E, et al. Laparoscopic radical prostatectomy: assessment after 240 procedures. Urol Clin North Am 2001; 28 (1): 189–202

    Article  PubMed  CAS  Google Scholar 

  61. Schuessler WW, Schulam PG, Clayman RV, et al. Laparoscopic radical prostatectomy: initial short-term experience. Urology 1997; 50 (6): 854–7

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

No sources of funding were used in the preparation of this manuscript. The authors have no potential conflicts of interest directly relevant to the contents of this manuscript.

Author information

Authors and Affiliations

  1. Departments of Urology and Health Services, University of California, Los Angeles, USA

    Christopher S. Saigal &  Mark S. Litwin

Authors
  1. Christopher S. Saigal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark S. Litwin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark S. Litwin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saigal, C.S., Litwin, M.S. The Economic Costs of Early Stage Prostate Cancer. Pharmacoeconomics 20, 869–878 (2002). https://doi.org/10.2165/00019053-200220130-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00019053-200220130-00001

Keywords

Search

Navigation