The Burden of Healthcare Costs Associated with Prostate Cancer in Ireland

Abstract

and elsewhere are thought to be largely explained by the increased rates of prostate specific antigen (PSA) testing among asymptomatic men (4-7). Although the European Randomised Study of Screening for Prostate Cancer (ERSPC) reported a 21% reduction of cancer-related death due to PSA screening compared to no screening (5), these benefits must be balanced against the harmful consequences of over-diagnosis and overtreatment of PCa (8-10). In comparison, the US PLCO trial found no such evidence of mortality reduction at 13 years' follow-up (11). The consequences of over-detection and over-diagnosis are of significant concern because not all PCas would have become clinically apparent within their lifetime; estimates of the pool of PCas susceptible to over-detection vary from 1%-2% in men aged 20-29 years to 59%-72% in men aged 90-99 years (12). Furthermore, the recent results of the ProtecT randomised trial on detection and treatment for PCa suggests that there is no significant difference between Active Monitoring (AM) and more radical treatment modalities in prostate-cancer-specific mortality (13).The Republic of Ireland (RoI) has one of the highest PCa rates in Europe and the fourth highest rate in the world