OBJECTIVE: The 2004 US Preventative Services Task Force (USPSTF) guidelines do not recommend routinely screening adults for @entity5 given no proven mortality reduction. A large cluster-randomized controlled screening trial in Kerala, India, in 2005, however, reported a significant reduction in mortality for screened male @entity286 and/or @entity167 users. In the United States, office-based screening efforts targeting males of high risk (regular use of @entity286 and/or @entity167 ) have been unsuccessful due to poor attendance. Given the newfound screening mortality benefit to this high-risk subpopulation, we sought to ascertain the cost-effectiveness threshold of a yearly, community outreach screening program for males more than 40 years regularly using @entity286 and/or @entity167 . STUDY DESIGN: Markov decision analysis model; societal perspective. METHODS: A literature search was performed to determine event probabilities, health utilities, and cost parameters to serve as model inputs. Screen versus No-Screen strategies were modeled using assumptions and published data. The primary outcome was the difference in costs and quality-adjusted life-years (QALYs) between the two cohorts, representing the potential budget for a screening program. One-way sensitivity analysis was performed for several key parameters. RESULTS: The No-Screen arm was dominated with an incremental cost of  258 and an @entity2166 . Using the  75,000/QALY metric, the maximum allowable budget for a screening program equals  3,363 ( 258 +  3,105) per screened @entity1 over a 40-year time course. CONCLUSION: Given the significant health benefits and financial savings via early detection in the screened cohort, a community-based screening program targeting high-risk males is likely to be cost-effective.

The cost-effectiveness of community-based screening for XXXX in high-risk males in the United States: a Markov decision analysis approach.

@entity1 :: ('9606', 'Species') :: ['person'] @entity286 :: ('4097', 'Species') :: ['tobacco'] @entity5 :: ('MESH:D009369', 'Disease') :: ['oral cancer'] @entity167 :: ('CHEBI:16236', 'Chemical') :: ['alcohol'] @entity2166 :: ('MESH:D000275', 'Disease') :: ['incremental effectiveness of -0.0414 QALYs']
@entity5 :: (MESH:D009369,Disease) :: ['oral cancer']
