Screening for lung cancer with CT: a preliminary cost-effectiveness analysis

Area of Science:

• Health Economics
• Oncology
• Diagnostic Imaging

Background:

• Lung cancer remains a leading cause of cancer mortality globally.
• Early detection significantly improves patient outcomes and survival rates.
• The economic implications of implementing widespread lung cancer screening are crucial for healthcare policy.

Purpose of the Study:

• To evaluate the potential cost-effectiveness of lung cancer screening using computed tomography (CT).
• To determine the threshold for early cancer detection that makes CT screening economically viable.
• To analyze screening costs and benefits from a national payer perspective.

Main Methods:

• Utilized incremental cost-effectiveness ratios (ICERs) for two hypothetical cohorts.
• One cohort underwent CT screening for 5 years; the other received usual care.
• Projected cost streams and life expectancies, considering variations in screening yield and treatment costs.

Main Results:

• In a worst-case scenario, CT screening cost approximately $48,000 per life-year gained.
• Cost-effectiveness was contingent on detecting at least 50% of lung cancers at a localized stage.
• Lower detection rates of localized cancers resulted in higher cost-effectiveness ratios.

Conclusions:

• Lung cancer screening with CT is likely cost-effective if it enables early detection of over 50% of cancers.
• The economic value of screening is directly linked to its effectiveness in identifying localized disease.
• Further research may refine cost-effectiveness based on specific screening protocols and population characteristics.