Evidence map›Paper›PMID 37296430›Full record

Trial reportBMC health services research2023

Impact of PSA testing on secondary care costs in England and Wales: estimates from the Cluster randomised triAl of PSA testing for Prostate cancer (CAP).

Joanna C Thorn, Emma L Turner, Eleanor I Walsh, Jenny L Donovan, David E Neal, Freddie C Hamdy, Richard M Martin, Sian M Noble

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Joanna C ThornBristol Medical School, Population Health Sciences, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK. joanna.thorn@bristol.ac.uk.ORCID http://orcid.org/0000-0001-8962-2428
Emma L TurnerBristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
Eleanor I WalshBristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
Jenny L DonovanBristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
David E NealNuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
Freddie C HamdyNuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
Richard M MartinBristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
Sian M NobleBristol Medical School, Population Health Sciences, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK.

Funding

Cancer Research UK 15064Cancer Research UK 24432Cancer Research UK C11043/A4286, C18281/A8145, C18281/A11326, C18281/A15064 and C18281/A24432
6 · The paper itself

Abstract

backgroundScreening men for prostate cancer using prostate-specific antigen (PSA) testing remains controversial. We aimed to estimate the likely budgetary impact on secondary care in England and Wales to inform screening decision makers.

methodsThe Cluster randomised triAl of PSA testing for Prostate cancer study (CAP) compared a single invitation to men aged 50-69 for a PSA test with usual care (no screening). Routinely collected hospital care data were obtained for all men in CAP, and NHS reference costs were mapped to each event via Healthcare Resource Group (HRG) codes. Secondary-care costs per man per year were calculated, and cost differences (and population-level estimates) between arms were derived annually for the first five years following randomisation.

resultsIn the first year post-randomisation, secondary-care costs averaged across all men (irrespective of a prostate cancer diagnosis) in the intervention arm (n = 189279) were £44.80 (95% confidence interval: £18.30-£71.30) higher than for men in the control arm (n = 219357). Extrapolated to a population level, the introduction of a single PSA screening invitation could lead to additional secondary care costs of £314 million.

conclusionsIntroducing a single PSA screening test for men aged 50-69 across England and Wales could lead to very high initial secondary-care costs.

Indexed as

Prostate-Specific AntigenProstatic NeoplasmsEnglandHumansMaleMass ScreeningSecondary Health CareWalesProstate-Specific AntigenBudget impact analysisCost-effectiveness analysisEconomic evaluationProstate cancer screeningSecondary care

Identifiers

PMID37296430
PMCPMC10257301

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.