This paper will focus on the economics of prostate cancer screening.
The American Cancer Society states that cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death (10). According to the Centers for Disease Control and Prevention, cancer is the second leading cause of death. In 2002 alone, half a million Americans will die of this disease. Of this numerical figure, it is estimated that perhaps more than 1,500 individuals a day will die. In addition, one of every four deaths in America is from cancer (9).
Among Medicare-age men, prostate cancer is a common and serious malignancy. The American Cancer Society (ACS) indicates that in the year 2002, 189,000 men in the United States are expected to be diagnosed with the disease and of this number, it is projected that 30,200 men will dies this year of prostate cancer. In the United States, this form of cancer is the second leading cause of death in men and it accounts for approximately 11% of male cancer related deaths. Other statistical facts presented by the ACS indicates that among men diagnosed with prostate cancer, 97% survive at least 5 years, 79% survive at least 10 years, and 57% survive at least 15 years. These stats include all stages and grades of prostate cancer but does not account for men who die from other causes. Due to the alarming statistics presented concerning this illness, many health professionals and organizations are promoting screening detection (1).
In reference to biology, the prostate is a golf-ball size gland that helps produce semen, the fluid ejaculated with sperm. It is located beneath the bladder and surrounds the urethra through which urine passes as it is voided. The majority of early prostate cancer seems to grow slowly, with doubling times of two or more years. An indicator of the future course of prostate cancer is predicted by tumor grade and stage. The age of the patient does not seem to play a role in the rate at which tumors spread and become life threatening. At the present moment, determining the stage of prostate cancer without surgery is unreliable. As soon as the cancer spreads to bones or other organs, hormonal treatments can only achieve temporary remissions often measured in months.
African-American men and men with a family history of prostate cancer are at most risk. Statistical date presented by Philip W. Kantoff, MD, Associate Professor of Medicine, Harvard Medical School and Director points out that among African-Americans, in the world, this population comprises 224 cases per 100,000. In comparison to other populations, the incidence of prostate cancer in African-Americans stands in stark contrast to the incidence in white Americans with 150 cases per 100,000 and among men in Western Europe, 39.6 cases per 100,000, Japan, 8.5 cases per 100,000, and China, 1.1 cases per 100,000 (2).
In addition to being an African-American...