Life expectancy and the value of early detection

被引：27

作者：

Howard, DH ^{[1
]}

机构：

[1] Emory Univ, Rollins Sch Publ Hlth, Dept Hlth Policy & Management, Atlanta, GA 30322 USA

来源：

JOURNAL OF HEALTH ECONOMICS | 2005年 / 24卷 / 05期

关键词：

screening; cost-effectiveness; prognosis; life expectancy; cancer;

D O I：

10.1016/j.jhealeco.2005.03.002

中图分类号：

F [经济];

学科分类号：

02 ;

摘要：

This paper presents a model of the benefits and costs of early detection of asymptomatic disease as they vary by age. The benefits of early detection tend toward zero as the risk of death from competing causes increases. Costs per detected case also decline with age, assuming that disease incidence rises with age, but are always strictly positive. On balance, there is always an age limit beyond which the costs associated with early detection outweigh the benefits. Application of the model to prostate cancer screening suggests that early detection above age 70 or so is not cost-effective. (c) 2005 Elsevier B.V. All rights reserved.

引用

页码：891 / 906

页数：16

共 29 条

[1] The impact of co-morbidity on life expectancy among men with localized prostate cancer [J].

Albertsen, PC ;

Fryback, DG ;

Storer, BE ;

Kolon, TF ;

Fine, J .

JOURNAL OF UROLOGY, 1996, 156 (01) :127-132

[2] Do older men benefit from curative therapy of localized prostate cancer? [J].

Alibhai, SMH ;

Naglie, G ;

Nam, R ;

Trachtenberg, J ;

Krohn, MD .

JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (17) :3318-3327

[3]

[Anonymous], 2004, NATL VITAL STAT REPO

[4] Comorbidities and the willingness to pay for health improvements [J].

Bleichrodt, H ;

Crainich, D ;

Eeckhoudt, L .

JOURNAL OF PUBLIC ECONOMICS, 2003, 87 (11) :2399-2406

[5] Screening and preventable illness [J].

Byrne, MM ;

Thompson, P .

JOURNAL OF HEALTH ECONOMICS, 2001, 20 (06) :1077-1088

[6] How accurate are physicians' clinical predictions of survival and the available prognostic tools in estimating survival times in terminally ill cancer patients? A systematic review [J].

Chow, E ;

Harth, T ;

Hruby, G ;

Finkelstein, J ;

Wu, J ;

Danjoux, C .

CLINICAL ONCOLOGY, 2001, 13 (03) :209-218

[7] The role of prognosis in clinical decision making [J].

Christakis, NA ;

Sachs, GA .

JOURNAL OF GENERAL INTERNAL MEDICINE, 1996, 11 (07) :422-425

[8] Lead times and overdetection due to prostate-specific antigen screening:: Estimates from the European randomized study of screening for prostate cancer [J].

Draisma, G ;

Boer, R ;

Otto, SJ ;

van der Cruijsen, IW ;

Damhuis, RAM ;

Schröder, FH ;

de Koning, HJ .

JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2003, 95 (12) :868-878

[9]

Etzioni R, 1998, AM J EPIDEMIOL, V148, P775

[10] Prostate-specific antigen testing in black and white men: An analysis of Medicare claims from 1991-1998 [J].

Etzioni, R ;

Berry, KM ;

Legler, JM ;

Shaw, P .

UROLOGY, 2002, 59 (02) :251-255

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