The economic impact of opportunistic PSA screening: a real-world cost analysis from China amid evolving policy landscape

BACKGROUND: The clinical value of prostate-specific antigen (PSA) screening remains debated, and health economic evidence from real-world Chinese screening programs is lacking. This study aimed to determine whether PSA screening reduces prostate cancer treatment costs in China. RESEARCH DESIGN AND METHODS: Using propensity score matching within a policy-driven community screening initiative in China, 61 screening-detected prostate cancer patients were matched with 61 symptom-detected controls. All patients were diagnosed and treated at the same central hospital. Total direct medical costs (including examination, hospitalization, surgery, chemotherapy, and radiotherapy) were compared between the two groups. CONCLUSIONS: This first direct economic evidence from China suggests that PSA screening is associated with substantially reduced treatment costs, likely attributable to earlier diagnosis and less intensive treatment. These findings support the economic case for considering organized PSA screening as a preventive health measure in China. Further multicenter studies with longer follow-up are warranted to confirm these results.