The cost to Medicare of screening elderly men in the United States for prostate cancer was $447 million in 2009, with about three-quarters of the cost associated with biopsy-related procedures, according to a study published online in Cancer.

Xiaomei Ma, Ph.D., from Yale University in New Haven, Conn., and colleagues analyzed data on prostate-specific antigen-based prostate cancer screening costs for 94,652 male Medicare recipients (66 to 99 years old) who had not been diagnosed with prostate cancer; the participants were followed from 2006 to 2009.

The researchers found that 51.2 percent of men underwent screening, and of these, 2.9 percent underwent biopsy. In 2009 U.S. dollars, the mean annual screening cost was $447 million, ranging from $17 to $62 per person depending on hospital referral region. Men in regions with the highest screening costs were significantly more likely to be diagnosed with prostate cancer and localized cancer. Biopsy-related procedures accounted for 72 percent of overall costs and varied across regions.

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“Medicare prostate cancer screening-related expenditures are substantial, vary considerably across regions, and are positively associated with rates of cancer diagnosis,” Ma and colleagues conclude.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.