Economic Evaluation of Prostate Cancer Screening Test as a National Cancer Screening Program in South Korea

Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested addingprostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started acontroversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this studywas to provide economic evidence to the decision makers of the NCSP. Materials and
Methods: A cost-utilityanalysis was performed on the adoption of PSA screening program among men aged 50-74-years in Koreafrom the healthcare system perspective. Several data sources were used for the cost-utility analysis, includinggeneral health screening data, the Korea Central Cancer Registry, national insurance claims data, and causeof mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-faceinterview for typical men aged 40 to 69 was conducted using a Time-Trade Off method.
Results: As a result, theincrease of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental costeffectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on theincidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results wereconsistent with the base analysis.
Conclusions: Under Korean circumstances with a relatively low incidence rateof prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostatecancer screening would not be beneficial until further evidence is provided in the future.