| Summary: | 碩士 === 國立陽明大學 === 國際衛生碩士學位學程 === 106 === Background: Prostate Cancer Screening has long been a hotly debated topic because its cost-effectiveness is constantly being questioned. Over the years, Urologist Dr. Dwayne Thwaites and his team have gone above and beyond in the St. Kitts-Nevis cancer screening arena. Beginning in 2007 in Nevis and 2014 in St. Kitts, Urology Associates Free Annual Prostate Screening Drive has been faithfully serving the federation in January of each year. The incessant increase in the attendance implies that the program is not only a success, but that perhaps the country has seen a decrease in prostate cancer incidence and prevalence. The purpose of this study was to evaluate the cost-effectiveness of this program and its effect on prostate cancer mortality and morbidity; as well as to address the controversy surrounding prostate cancer screening.
Methods: A cost-effective analysis (CEA) was conducted to assess the progress and success of the above-mentioned annual mass prostate cancer screening program. This was done by calculating an Incremental Cost-effectiveness Ratio (ICER) using data collected from St. Kitts and Nevis Health Information Units. The ICER compared the monetary costs and health outcomes of the intervention (screening program) in Nevis, to the same of the alternative of no screening program in St. Kitts. For this study the health outcome was measured in Disability Life Adjusted Years (DALYs) and the time frame was that of 2007 – 2014.
Results: ICER calculations exclusive of future medical costs revealed a USD$/DALY = $4, 643.02/DALY, while that inclusive of future medical costs revealed a US$/DALY = $-16, 015.62/DALY. Cost per death averted was calculated at $22, 836.72/Death averted, while cost per case detected was $6851.02/Case detected.
Conclusion: The annual mass prostate cancer screening program on Nevis dubbed Urology Associates Free Annual Prostate Screening Drive is cost-effective per the DALY evaluated for this study.
Keywords: Cost-effectiveness Analysis, St. Kitts-Nevis, Prostate Cancer, Cancer Screening, Prostate Specific Antigen, Digital Rectal Exam, Health Economics, Program Evaluation.
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