Chest
Clinical InvestigationsCANCERThe Cost-Effectiveness of Low-Dose CT Screening for Lung Cancer*: Preliminary Results of Baseline Screening
Section snippets
Decision-Analytic Model
We evaluated the cost-effectiveness of a program consisting of a single baseline low-dose screening CT scan for the diagnosis of non-small cell lung cancer in persons aged ≥ 60 years with at least a 10-pack-year history of smoking, fit to undergo thoracic surgery, and with no prior history of cancer (except nonmelanoma cancer of the skin). The comparison program, used to represent the alternative base case, was usual care, under which lung cancer is detected by symptoms and/or signs or is
Results
Based on the ELCAP results, we assumed that 233 of 1,000 subjects will have 1 to 6 noncalcified nodules, and that 27 individuals will receive diagnoses of non-small cell lung cancer on baseline CT scan screening. Table 1 shows the number of diagnostic CT scans and FNAs that were performed as part of the workup of subjects with a positive test result.
The stage distribution of lung cancers diagnosed under usual care was significantly different from that identified by CT scan screening. As shown
Discussion
Our analysis suggested that the cost-effectiveness ratio of a single baseline CT scan for the lung cancer screening of high-risk individuals is likely to be within the range of practice and policy acceptability, and compares favorably to the cost-effectiveness ratios of other screening programs.22
The costs and resource utilization used for the analysis were obtained from The New York-Presbyterian Hospital. Local and regional differences in the costs of medical care and treatment modalities for
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