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dc.contributor.authorLao, Chunhuanen_NZ
dc.contributor.authorEdlin, Richarden_NZ
dc.contributor.authorRouse, Paulen_NZ
dc.contributor.authorBrown, Charisen_NZ
dc.contributor.authorHolmes, Michaelen_NZ
dc.contributor.authorGilling, Peteren_NZ
dc.contributor.authorLawrenson, Rossen_NZ
dc.date.accessioned2017-08-13T21:26:07Z
dc.date.available2017en_NZ
dc.date.available2017-08-13T21:26:07Z
dc.date.issued2017en_NZ
dc.identifier.citationLao, C., Edlin, R., Rouse, P., Brown, C., Holmes, M., Gilling, P., & Lawrenson, R. (2017). The cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer. BMC Cancer, 17:529.en
dc.identifier.issn1471-2407en_NZ
dc.identifier.urihttps://hdl.handle.net/10289/11270
dc.description.abstractBackground: Radical prostatectomy is the most common treatment for localised prostate cancer in New Zealand. Active surveillance was introduced to prevent overtreatment and reduce costs while preserving the option of radical prostatectomy. This study aims to evaluate the cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy. Methods: Markov models were constructed to estimate the life-time cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer patients aged 45–70 years, using national datasets in New Zealand and published studies including the SPCG-4 study. This study was from the perspective of the Ministry of Health in New Zealand. Results: Radical prostatectomy is less costly than active surveillance in men aged 45–55 years with low risk localised prostate cancer, but more costly for men aged 60–70 years. Scenario analyses demonstrated significant uncertainty as to the most cost-effective option in all age groups because of the unavailability of good quality of life data for men under active surveillance. Uncertainties around the likelihood of having radical prostatectomy when managed with active surveillance also affect the cost-effectiveness of active surveillance against radical prostatectomy. Conclusions: Active surveillance is less likely to be cost-effective compared to radical prostatectomy for younger men diagnosed with low risk localised prostate cancer. The cost-effectiveness of active surveillance compared to radical prostatectomy is critically dependent on the ‘trigger’ for radical prostatectomy and the quality of life in men on active surveillance. Research on the latter would be beneficial.
dc.format.mimetypeapplication/pdf
dc.language.isoen
dc.publisherBioMed Centralen_NZ
dc.rights© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.subjectActive surveillance
dc.subjectCost-effectiveness
dc.subjectLow risk localised prostate cancer
dc.subjectRadical prostatectomy
dc.titleThe cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate canceren_NZ
dc.typeJournal Article
dc.identifier.doi10.1186/s12885-017-3522-z
dc.relation.isPartOfBMC Canceren_NZ
pubs.elements-id200936
pubs.organisational-group/Waikato
pubs.organisational-group/Waikato/2018 PBRF
pubs.organisational-group/Waikato/VICH
pubs.organisational-group/Waikato/VICH/2018 PBRF_VICH


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