Lung cancer screening in Lithuania: a cost-effectiveness analysis

Area of Science:

• Public Health
• Health Economics
• Oncology

Background:

• Lung cancer remains a leading cause of cancer mortality globally.
• Early detection through screening significantly improves patient outcomes and survival rates.
• Identifying cost-effective screening strategies is crucial for healthcare resource allocation.

Purpose of the Study:

• To evaluate the cost-effectiveness of annual volumetric-enabled low-dose computed tomography (LDCT) lung cancer screening (LCS) in Lithuania.
• To compare the NELSON screening outcomes-based LDCT strategy against no screening for a high-risk population.
• To assess the health benefits and financial implications of LCS from the Lithuanian healthcare system's perspective.

Main Methods:

• Adaptation of a decision tree with a Markov trace model for health and economic assessment.
• Simulation of annual LDCT screening versus no screening for individuals aged 50-74 with a history of smoking.
• Analysis of clinical benefits (stage-specific cancer detection, averted deaths), costs, quality-adjusted life years (QALYs), and life-years gained.

Main Results:

• Annual LDCT LCS identified 6117 additional early-stage lung cancers and averted 1874 late-stage cases.
• Screening averted 2606 premature lung cancer deaths and gained 21,639 life-years at a 46.5% uptake rate.
• The incremental cost-effectiveness ratio was €1372 per QALY, with €21.1 million in incremental costs and 15,391 QALYs gained.

Conclusions:

• Annual volumetric-enabled LDCT lung cancer screening is a cost-effective strategy for the high-risk population in Lithuania.
• The study demonstrates significant clinical benefits, including reduced premature mortality and increased life-years.
• The findings support the implementation of LDCT-based LCS programs in similar healthcare settings.