前列腺癌是男性中最常见的恶性肿瘤，前列腺特异性抗原 (PSA) 筛查测试呈阳性后，患者可能会接受更昂贵的诊断测试。然而，与测试相关的自付费用 (OOPC) 可能会妨碍患者完成筛查过程，此前尚未进行量化。对接受私人保险接受前列腺癌筛查的患者进行后续诊断测试（即前列腺活检和/或磁共振成像 [MRI]）的 OOPC 进行了估计。年龄 55 至 69 岁的男性接受基于 PSA 的前列腺癌筛查2010 年至 2020 年是从 IBM Marketscan 数据库中确定的。将筛选后 12 个月内接受后续诊断测试的患者人数制成表格，将患者分为三组：(1) 仅活检、(2) 仅 MRI 和 (3) MRI 活检。在研究期间，确定了每组的非零费用分摊患者和计算出的经通货膨胀调整的 OOPC，添加共付额、共同保险和免赔额。在 2010 年至 2020 年筛选的患者 (n = 3,075,841) 中，91,850 名患者接受了第二次治疗PSA 测试和 PSA 水平升高，其中 40,329 人（43.9%）接受了后续诊断测试。其中超过 75% 的患者经历了费用分摊，并且在研究期间，仅接受活检的患者（79 美元至 214 美元）、仅接受 MRI 的患者（81 美元至 490 美元）以及 MRI 和活检的患者（353 美元至 620 美元）的中位 OOPC 大幅上升。前列腺癌筛查后诊断测试中的 OOPC 很常见，而且还在不断增加。这项工作与美国癌症协会最近的立场声明一致，即付款人应消除癌症筛查后诊断测试的费用分摊，这可能会破坏筛查过程。© 2024 美国癌症协会。

Prostate cancer is the most common malignancy among men and following a positive prostate-specific antigen (PSA) screening test, patients may undergo more expensive diagnostic testing. However, testing-related out-of-pocket costs (OOPCs), which may preclude patients from completing the screening process, have not been previously quantified. OOPCs for follow-up diagnostic testing (i.e., prostate biopsy and/or magnetic resonance imaging [MRI]) in patients with private insurance undergoing prostate cancer screening were estimated.Men ages 55 to 69 years old who underwent PSA-based prostate cancer screening from 2010 to 2020 from the IBM Marketscan database were identified. The number of patients undergoing follow-up diagnostic testing within 12 months of screening was tabulated, dividing patients into three groups: (1) biopsy only, (2) MRI only, and (3) MRI + biopsy. Over the study period, patients with nonzero cost-sharing and calculated inflation-adjusted OOPCs, adding copayment, coinsurance, and deductible payments, for each group were identified.Among screened patients (n = 3,075,841) from 2010 through 2020, 91,850 had a second PSA test and an elevated PSA level, of which 40,329 (43.9%) underwent subsequent diagnostic testing. More than 75% of these patients experienced cost-sharing, and median OOPCs rose substantially over the study period for patients undergoing biopsy only ($79 to $214), MRI only ($81 to $490), and MRI and biopsy ($353 to $620).OOPCs from diagnostic testing after prostate cancer screening are common and rising. This work aligns with the recent position statement from the American Cancer Society, that payers should eliminate cost-sharing, which may undermine the screening process, for diagnostic testing following cancer screening.© 2024 American Cancer Society.