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dc.contributor.author | 小林, 恭 | ja |
dc.contributor.author | 後藤, 励 | ja |
dc.contributor.author | 樋之津, 史郎 | ja |
dc.contributor.author | 小川, 修 | ja |
dc.contributor.alternative | Kobayashi, Takashi | en |
dc.contributor.alternative | Goto, Rei | en |
dc.contributor.alternative | Hinotsu, Shiro | en |
dc.contributor.alternative | Ogawa, Osamu | en |
dc.date.accessioned | 2013-05-01T06:39:12Z | - |
dc.date.available | 2013-05-01T06:39:12Z | - |
dc.date.issued | 2013-03 | - |
dc.identifier.issn | 0018-1994 | - |
dc.identifier.uri | http://hdl.handle.net/2433/173704 | - |
dc.description.abstract | In prostate specific antigen (PSA) -based prostate cancer mass screening, the optimal re-screening interval is still in question, although guidelines suggest that a prolonged interval would be safe and costsaving. We examined the socioeconomic feasibility of prolonged re-screening interval based on individual baseline PSA values. Markov decision-analytic models of prostate cancer screening were established for cost-effectiveness comparison of prolonged re-screening in men with low (≦1 ng/ml) PSA level (metainterval strategy) and annual re-screening in every participant (control strategy). Effectiveness and socioeconomic feasibility were evaluated according to quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER ; Δcost per ΔQALY), respectively. As a result, outcomes including cancer detection rates and stage shift suggested that these models well recapitulated actual prostate cancer mass screening. The meta-interval strategy was more cost-effective than the control strategy. The ICER for the control strategy with respect to the meta-interval strategy exceeded US$62, 000/QALY through the sensitivity analyses for every assumption. The meta-interval strategy was more effective and less expensive if the trade-off of impaired clinical outcomes caused by delayed detection was small. In conclusion, our models suggest that the meta-interval strategy is more cost-effective than annual screening. It can be even more effective if the interval is determined appropriately such that cancer can be detected within the therapeutic window. | en |
dc.format.mimetype | application/pdf | - |
dc.language.iso | jpn | - |
dc.publisher | 泌尿器科紀要刊行会 | ja |
dc.rights | 許諾条件により本文は2014-04-01に公開 | ja |
dc.subject | PSA-based prostate cancer screening | en |
dc.subject.ndc | 494.9 | - |
dc.title | ベースラインPSA値による検診間隔の個別設定は前立腺癌スクリーニングの効率を改善する : 数理モデルを用いた社会経済学的考察 | ja |
dc.title.alternative | Socioeconomic Advantages of Longer Screening Intervals for Men with Low Prostate-Specific Antigen Levels in Prostate Cancer Mass Screening | en |
dc.type | departmental bulletin paper | - |
dc.type.niitype | Departmental Bulletin Paper | - |
dc.identifier.ncid | AN00208315 | - |
dc.identifier.jtitle | 泌尿器科紀要 | ja |
dc.identifier.volume | 59 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | 159 | - |
dc.identifier.epage | 166 | - |
dc.textversion | publisher | - |
dc.sortkey | 03 | - |
dc.address | 京都大学大学院医学研究科泌尿器科学教室 | ja |
dc.address | 京都大学白眉センター・経済学研究科 | ja |
dc.address | 京都大学大学院医学研究科薬剤疫学分野 | ja |
dc.address | 京都大学大学院医学研究科泌尿器科学教室 | ja |
dc.startdate.bitstreamsavailable | 2014-04-01 | - |
dc.address.alternative | The Department of Urology, Kyoto University Graduate School of Medicine | en |
dc.address.alternative | The Hakubi Center for Advanced Research, Kyoto University | en |
dc.address.alternative | The Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health | en |
dc.address.alternative | The Department of Urology, Kyoto University Graduate School of Medicine | en |
dc.identifier.pmid | 23633630 | - |
dcterms.accessRights | open access | - |
dc.identifier.pissn | 0018-1994 | - |
dc.identifier.jtitle-alternative | Acta urologica Japonica | la |
dc.identifier.jtitle-alternative | Hinyokika Kiyo | en |
出現コレクション: | Vol.59 No.3 |
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