A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions
A 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT) screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proo...
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| description | A 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT) screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proof to financial feasibility. The goal of this study was to determine whether LDCT screening for lung cancer in a commercially-insured population (aged 50-64) at high risk for lung cancer is cost-effective and to quantify the additional benefits of incorporating smoking cessation interventions in a lung cancer screening program.
The current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs) gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses.
The findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50-64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical recommendations. |
| doi_str_mv | 10.1371/journal.pone.0071379 |
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The current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs) gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses.
The findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50-64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical recommendations.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0071379</identifier><identifier>PMID: 23940744</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adults ; Aged ; Analysis ; Cancer ; Cancer research ; Cancer screening ; Carcinoma, Non-Small-Cell Lung - diagnosis ; Carcinoma, Non-Small-Cell Lung - economics ; Carcinoma, Non-Small-Cell Lung - prevention & control ; CAT scans ; Computed tomography ; Computer Simulation ; Cost benefit analysis ; Drug addiction ; Early Detection of Cancer - economics ; Economic aspects ; Feasibility studies ; Female ; Health aspects ; Health Promotion - economics ; Health risk assessment ; Health risks ; Humans ; Lung cancer ; Lung diseases ; Lung Neoplasms - diagnosis ; Lung Neoplasms - economics ; Lung Neoplasms - prevention & control ; Male ; Mammography ; Mass Screening - economics ; Medical screening ; Medicine ; Middle Aged ; Models, Economic ; Mortality ; Quality-Adjusted Life Years ; Risk ; Screening ; Sensitivity analysis ; Smoking ; Smoking - adverse effects ; Smoking Cessation ; Social and Behavioral Sciences ; Studies</subject><ispartof>PloS one, 2013-08, Vol.8 (8), p.e71379-e71379</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Villanti et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Villanti et al 2013 Villanti et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-c203ce2976dc40cad5c6763b9d86bea48157a87d79a7b096c7142079403dc0793</citedby><cites>FETCH-LOGICAL-c692t-c203ce2976dc40cad5c6763b9d86bea48157a87d79a7b096c7142079403dc0793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737088/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737088/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23871,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23940744$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gorlova, Olga Y.</contributor><creatorcontrib>Villanti, Andrea C</creatorcontrib><creatorcontrib>Jiang, Yiding</creatorcontrib><creatorcontrib>Abrams, David B</creatorcontrib><creatorcontrib>Pyenson, Bruce S</creatorcontrib><title>A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>A 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT) screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proof to financial feasibility. The goal of this study was to determine whether LDCT screening for lung cancer in a commercially-insured population (aged 50-64) at high risk for lung cancer is cost-effective and to quantify the additional benefits of incorporating smoking cessation interventions in a lung cancer screening program.
The current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs) gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses.
The findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50-64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical recommendations.</description><subject>Adults</subject><subject>Aged</subject><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer research</subject><subject>Cancer screening</subject><subject>Carcinoma, Non-Small-Cell Lung - diagnosis</subject><subject>Carcinoma, Non-Small-Cell Lung - economics</subject><subject>Carcinoma, Non-Small-Cell Lung - prevention & control</subject><subject>CAT scans</subject><subject>Computed tomography</subject><subject>Computer Simulation</subject><subject>Cost benefit analysis</subject><subject>Drug addiction</subject><subject>Early Detection of Cancer - economics</subject><subject>Economic aspects</subject><subject>Feasibility studies</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health Promotion - economics</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>Lung Neoplasms - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Villanti, Andrea C</au><au>Jiang, Yiding</au><au>Abrams, David B</au><au>Pyenson, Bruce S</au><au>Gorlova, Olga Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-08-07</date><risdate>2013</risdate><volume>8</volume><issue>8</issue><spage>e71379</spage><epage>e71379</epage><pages>e71379-e71379</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>A 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT) screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proof to financial feasibility. The goal of this study was to determine whether LDCT screening for lung cancer in a commercially-insured population (aged 50-64) at high risk for lung cancer is cost-effective and to quantify the additional benefits of incorporating smoking cessation interventions in a lung cancer screening program.
The current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs) gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses.
The findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50-64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical recommendations.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23940744</pmid><doi>10.1371/journal.pone.0071379</doi><tpages>e71379</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adults Aged Analysis Cancer Cancer research Cancer screening Carcinoma, Non-Small-Cell Lung - diagnosis Carcinoma, Non-Small-Cell Lung - economics Carcinoma, Non-Small-Cell Lung - prevention & control CAT scans Computed tomography Computer Simulation Cost benefit analysis Drug addiction Early Detection of Cancer - economics Economic aspects Feasibility studies Female Health aspects Health Promotion - economics Health risk assessment Health risks Humans Lung cancer Lung diseases Lung Neoplasms - diagnosis Lung Neoplasms - economics Lung Neoplasms - prevention & control Male Mammography Mass Screening - economics Medical screening Medicine Middle Aged Models, Economic Mortality Quality-Adjusted Life Years Risk Screening Sensitivity analysis Smoking Smoking - adverse effects Smoking Cessation Social and Behavioral Sciences Studies |
| title | A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-16T06%3A08%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20cost-utility%20analysis%20of%20lung%20cancer%20screening%20and%20the%20additional%20benefits%20of%20incorporating%20smoking%20cessation%20interventions&rft.jtitle=PloS%20one&rft.au=Villanti,%20Andrea%20C&rft.date=2013-08-07&rft.volume=8&rft.issue=8&rft.spage=e71379&rft.epage=e71379&rft.pages=e71379-e71379&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0071379&rft_dat=%3Cgale_plos_%3EA478404252%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1430254637&rft_id=info:pmid/23940744&rft_galeid=A478404252&rft_doaj_id=oai_doaj_org_article_2e4df624fb0348538508fac04f1f730e&rfr_iscdi=true |