A combination of conservative screening and selective treatment strategies can make screening for prostate cancer cost effective, according to an economic analysis published March 24 in JAMA Oncology. According to testing of various models, less frequent screening and more restrictive biopsy criteria, when accompanied by active surveillance of low-risk cancer, hold the most economic promise. The incidence of early-stage prostate cancer and rates of prostate-specific antigen (PSA) screening have both declined following the 2012 U.S. Preventive Services Task Force (USPSTF) recommendation against PSA screening as routine primary care for men. While there have been calls for more personalized approaches for prostate cancer screening and management, there is no consensus strategy of how to implement screening that preserves the benefits of detection, while cutting the harm associated with overdiagnosis and overtreatment. “This study provides, to our knowledge, the first quantitative framework to evaluate the comparative effectiveness of PSA-based screening strategies and selective treatment approaches, and it addresses an urgent need for direction concerning the future of PSA screening in the United States,” write the authors led by Joshua Roth, Ph.D., from University of Washington, Seattle. “Our work indicates that strategies with a conservative screening frequency (e.g., quadrennial) and/or a higher PSA […]