A cost-effectiveness model of prostate cancer screening

Prostate cancer is the second most common cause of male cancer death in the UK, however due to the uncertainty around the health benefits and cost-effectiveness of a national screening programme, organised screening has not been adopted. A cost-effectiveness analysis was therefore conducted to examine the impact of a national prostate cancer screening programme on behalf of the UK National Screening Committee. A discrete event simulation model was developed to evaluate the use of the prostate specific antigen (PSA) blood test as a screening tool in the UK. The model comprises four parts: a disease natural history model which models the underlying disease itself; a calibration module which enables unobservable model parameters to be calibrated to observable data using a Metropolis-Hastings algorithm; a screening component which allows different screening options to be imposed on the population; and a resource impact model which calculates the resource implications of the alternative screening options. The model estimates incidence, lead time, over-detection, quality of life years (QALYs), mortality and resource implications of single and repeat screening strategies.