Researchers at McGill University Health Center find that active surveillance of men with low-risk prostate cancer may be better for quality of life and is cost-effective compared with immediate treatment.

According to a study published in in Canadian Medical Association’s CMAJ Open, researchers found that active surveillance with follow-up over five years could save about $96 million CDN at the national level because the high cost of treating cancer that was at low risk of progressing could be avoided. With active surveillance, the cost per patient for the first year and the subsequent five years of follow-up was estimated at $6,200 compared with $13,735 for immediate treatment.

For the study, researchers developed a Markov model to estimate cancer costs for active surveillance-- watching and waiting to see if cancer progresses--and immediate treatment of patients in Quebec, Canada.

"Despite published guideline recommendations, overtreatment of prostate cancer is common in the United States and elsewhere, with about 70 percent to 90 percent of patients undergoing immediate treatment," writes lead author Alice Dragomir. "In Canada, about 75 percent of patients with prostate cancer have received immediate treatment from 1995 through 2002. It is believed today that more than half of these patients did not require immediate treatment at the time of diagnosis, but the treatment led to cost and morbidity."

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