Cost-effectiveness of serum, urine, and tissue-based prostate cancer biomarkers.

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Current Opinion in Urology Pub Date : 2025-07-01 Epub Date: 2025-04-25 DOI:10.1097/MOU.0000000000001293

Veerain K Gupta, Brian D Cortese, Ruchika Talwar

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引用次数: 0

Abstract

Purpose of review: Prostate cancer remains a leading malignancy among men in the United States. While prostate-specific antigen (PSA) screening improves early detection, it also leads to over-diagnosis and over-treatment. Biomarkers offer a promising solution for risk stratification and guiding treatment decisions. This review examines the cost-effectiveness of serum, urine, and tissue-based biomarkers to assess their impact on healthcare expenditures and clinical decision-making.

Recent findings: Serum-based biomarkers like 4Kscore and PHI reduce unnecessary biopsies and healthcare costs. Urine-based biomarkers, including SelectMDx and ExoDx Prostate IntelliScore (EPI), have shown potential to optimize prostate cancer detection while being more cost-effective than some serum-based alternatives. Tissue-based biomarkers, such as OncotypeDx and Decipher, help in treatment selection, though their economic impact varies. Economic analyses suggest that biomarkers can enhance clinical decision-making while reducing healthcare expenditures, but real-world validation remains limited.

Summary: Prostate cancer biomarkers improve risk stratification and may lower healthcare costs. However, variations in cost-effectiveness, reimbursement policies, and guideline recommendations limit widespread adoption. Prospective studies are needed to validate real-world cost savings and refine biomarker integration into clinical practice. Addressing financial and policy challenges is essential to ensure equitable access and maximize their impact on prostate cancer management.

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基于血清、尿液和组织的前列腺癌生物标志物的成本效益。

综述目的：前列腺癌仍然是美国男性的主要恶性肿瘤。虽然前列腺特异性抗原（PSA）筛查有助于早期发现，但也会导致过度诊断和过度治疗。生物标志物为风险分层和指导治疗决策提供了一个有希望的解决方案。本综述研究了血清、尿液和基于组织的生物标志物的成本效益，以评估它们对医疗保健支出和临床决策的影响。最近的研究发现：基于血清的生物标志物，如4Kscore和PHI，减少了不必要的活组织检查和医疗成本。基于尿液的生物标志物，包括SelectMDx和ExoDx前列腺IntelliScore (EPI)，已经显示出优化前列腺癌检测的潜力，同时比一些基于血清的替代品更具成本效益。基于组织的生物标志物，如OncotypeDx和Decipher，有助于治疗选择，尽管它们的经济影响各不相同。经济分析表明，生物标志物可以提高临床决策，同时减少医疗保健支出，但现实验证仍然有限。总结：前列腺癌生物标志物可改善风险分层，并可能降低医疗成本。然而，成本效益、报销政策和指南建议的变化限制了广泛采用。需要前瞻性研究来验证现实世界的成本节约，并将生物标志物整合到临床实践中。解决财政和政策挑战对于确保公平获取和最大限度地发挥其对前列腺癌管理的影响至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Urology 医学-泌尿学与肾脏学

CiteScore

5.00

自引率

4.00%

发文量

140

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Urology delivers a broad-based perspective on the most recent and most exciting developments in urology from across the world. Published bimonthly and featuring ten key topics – including focuses on prostate cancer, bladder cancer and minimally invasive urology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.