Economic burden of illness associated with localized prostate cancer in the United States.

Prior studies have established the economic burden of prostate cancer on society. However, changes to screening, novel therapies and increased use of active surveillance (AS) create a need for an updated analysis. A deterministic, decision-analytic model was developed to estimate medical costs associated with localized prostate cancer over 10 years. 10-year costs averaged $45,957, $99,445 and $188,928 for low-, intermediate- and high-risk patients, respectively. For low-risk patients, AS 10-year costs averaged $33,912/patient, whereas definitive treatment averaged $49,667/patient. Despite higher failure rates in intermediate-risk patients, AS remained less costly than definitive treatment, with 10-year costs averaging $90,614/patient and $99,394/patient, respectively. Broader incorporation of AS, guided by additional prognostic tools, may mitigate this growing economic burden.