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Rossi, Sabrina H., Klatte, Tobias, Usher-Smith, Juliet A., Fife, Kate, Welsh, Sarah J., Dabestani, Saeed, Bex, Axel, Nicol, David, Nathan, Paul, Stewart, Grant D. and Wilson, Edward C. F. 
ORCID: https://orcid.org/0000-0002-8369-1577
(2021)
A decision analysis evaluating screening for kidney cancer using focused renal ultrasound.
European Urology Focus, 7 (2).
pp. 407-419.
ISSN 2405-4569
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Abstract
Background: Screening for renal cell carcinoma (RCC) has been identified as a key research priority; however, no randomised control trials have been performed. Value of information analysis can determine whether further research on this topic is of value. Objective: To determine (1) whether current evidence suggests that screening is potentially cost-effective and, if so, (2) in which age/sex groups, (3) identify evidence gaps, and (4) estimate the value of further research to close those gaps. Design, setting, and participants: A decision model was developed evaluating screening in asymptomatic individuals in the UK. A National Health Service perspective was adopted. Intervention: A single focused renal ultrasound scan compared with standard of care (no screening). Outcome measurements and statistical analysis: Expected lifetime costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER), discounted at 3.5% per annum. Results and limitations: Given a prevalence of RCC of 0.34% (0.18–0.54%), screening 60-yr-old men resulted in an ICER of £18 092/QALY (€22 843/QALY). Given a prevalence of RCC of 0.16% (0.08–0.25%), screening 60-yr-old women resulted in an ICER of £37 327/QALY (€47 129/QALY). In the one-way sensitivity analysis, the ICER was <£30 000/QALY as long as the prevalence of RCC was ≥0.25% for men and ≥0.2% for women at age 60 yr. Given the willingness to pay a threshold of £30 000/QALY (€37 878/QALY), the population-expected values of perfect information were £194 million (€244 million) and £97 million (€123 million) for 60-yr-old men and women, respectively. The expected value of perfect parameter information suggests that the prevalence of RCC and stage shift associated with screening are key research priorities. Conclusions: Current evidence suggests that one-off screening of 60-yr-old men is potentially cost-effective and that further research into this topic would be of value to society. Patient summary: Economic modelling suggests that screening 60-yr-old men for kidney cancer using ultrasound may be a good use of resources and that further research on this topic should be performed.
| Item Type: | Article |
|---|---|
| Additional Information: | Copyright © 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
| Uncontrolled Keywords: | cost-effectiveness,kidney cancer,renal cell cancer,screening,ultrasound,urology,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2748 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Health Economics |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 13 Sep 2019 00:40 |
| Last Modified: | 22 Oct 2022 05:12 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/72178 |
| DOI: | 10.1016/j.euf.2019.09.002 |
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