Patterns of Medical Care Cost by Service Type Associated With Lung Cancer Screening

Lung cancer screening (LCS) enhances early stage cancer detection; however, its impact on health care costs in real-world clinical settings is not well understood. The objective of this study was to assess changes in health care costs during the 12 months before LCS compared with the 12 months after.

This retrospective study analyzed health care costs based upon Medicare's fee-for-service reimbursement system using data from the Population-based Research to Optimize the Screening Process Lung Consortium. We included individuals who met age and smoking LCS eligibility criteria and were engaged within 4 health care systems between February 5, 2015, and December 31, 2021. Generalized linear models estimated health care costs from the payer perspective during 12 months prior and 12 months post baseline LCS. We compared these costs to eligible individuals who did not receive LCS. Secondary analyses examined costs among the sample who completed LCS by positive versus negative scan results. We reported mean predicted costs with average values for all other explanatory variables.

We identified 10,049 eligible individuals who received baseline LCS and 15,233 who did not receive LCS. Receipt of LCS was associated with additional costs of $3698 compared with individuals not receiving LCS. Secondary analyses found costs increased by $11,664 among individuals with positive scans; however, no increases occurred among individuals with negative scans.

These findings suggest LCS was only associated with increased health care costs among patients with a positive scan. LCS is a potentially cost-effective approach to identify early stage lung cancer. Healthcare systems should prioritize strategies to improve LCS participation.