Lung cancer screening in Lithuania: a cost-effectiveness analysis

Area of Science:

• Public Health
• Oncology
• Health Economics

Background:

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

Purpose of the Study:

• To evaluate the cost-effectiveness of annual volumetric-enabled low-dose computed tomography (LDCT) lung cancer screening (LCS) versus no screening in Lithuania.
• To assess the health benefits and financial implications of LCS from a healthcare system perspective.
• To determine the incremental cost-effectiveness ratio (ICER) of implementing LCS.

Main Methods:

• A decision tree with a Markov model was adapted to simulate the lifetime outcomes of LCS.
• The study population included asymptomatic high-risk individuals aged 50-74 years with a history of smoking.
• Primary outcomes included lung cancer cases detected, premature deaths averted, life-years gained, quality-adjusted life-years (QALYs), and ICER.

Main Results:

• Annual LCS detected 6117 additional early-stage lung cancers and averted 1874 late-stage cases.
• The screening strategy averted 2606 premature lung cancer deaths and gained 21,639 life-years.
• The ICER was €1372 per QALY gained, with incremental costs of €21.1 million and 15,391 QALYs gained.

Conclusions:

• Annual volumetric-enabled LDCT lung cancer screening is a cost-effective strategy for high-risk populations in Lithuania.
• LCS offers substantial clinical benefits, including increased early-stage diagnoses and reduced mortality.
• The findings support the implementation of LDCT-based LCS programs to improve lung cancer outcomes.