Computed tomography screening for lung cancer in Hodgkin's lymphoma survivors: decision analysis and cost-effectiveness analysis
Background: Hodgkin's lymphoma patients have an elevated risk of developing lung cancer and may be targeted for lung cancer screening. We used a decision-analytic model to estimate the potential clinical benefits and cost-effectiveness of computed tomography (CT) screening for lung cancer in Ho...
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| Veröffentlicht in: | Annals of oncology 2006-05, Vol.17 (5), p.785-793 |
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| creator | Das, P. Ng, A. K. Earle, C. C. Mauch, P. M. Kuntz, K. M. |
| description | Background: Hodgkin's lymphoma patients have an elevated risk of developing lung cancer and may be targeted for lung cancer screening. We used a decision-analytic model to estimate the potential clinical benefits and cost-effectiveness of computed tomography (CT) screening for lung cancer in Hodgkin's lymphoma survivors. Materials and methods: We developed a Markov decision-analytic model to compare annual low-dose CT screening versus no screening in a hypothetical cohort of patients diagnosed with stage IA–IIB Hodgkin's lymphoma at age 25, with screening starting 5 years after initial diagnosis. We derived model parameters from published studies and the Surveillance, Epidemiology and End Results (SEER) Program, and assumed that stage-shift produces a survival benefit. Results: Annual CT screening increased survival by 0.64 years for smokers and 0.16 years for non-smokers. The corresponding benefits in quality-adjusted survival were 0.58 quality-adjusted life-years (QALYs) for smokers and 0.14 QALYs for non-smokers. The incremental cost-effectiveness ratios for annual CT screening compared with no screening were $34 100/QALY for smokers and $125 400/QALY for non-smokers. Conclusions: Our analysis suggests that if early promising results for lung cancer screening hold, CT screening for lung cancer may increase survival and quality-adjusted survival among Hodgkin's lymphoma survivors, with a benefit and incremental cost-effectiveness ratio for smokers comparable to that of other recommended cancer screening strategies. |
| doi_str_mv | 10.1093/annonc/mdl023 |
| format | Article |
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K. ; Earle, C. C. ; Mauch, P. M. ; Kuntz, K. M.</creator><creatorcontrib>Das, P. ; Ng, A. K. ; Earle, C. C. ; Mauch, P. M. ; Kuntz, K. M.</creatorcontrib><description>Background: Hodgkin's lymphoma patients have an elevated risk of developing lung cancer and may be targeted for lung cancer screening. We used a decision-analytic model to estimate the potential clinical benefits and cost-effectiveness of computed tomography (CT) screening for lung cancer in Hodgkin's lymphoma survivors. Materials and methods: We developed a Markov decision-analytic model to compare annual low-dose CT screening versus no screening in a hypothetical cohort of patients diagnosed with stage IA–IIB Hodgkin's lymphoma at age 25, with screening starting 5 years after initial diagnosis. We derived model parameters from published studies and the Surveillance, Epidemiology and End Results (SEER) Program, and assumed that stage-shift produces a survival benefit. Results: Annual CT screening increased survival by 0.64 years for smokers and 0.16 years for non-smokers. The corresponding benefits in quality-adjusted survival were 0.58 quality-adjusted life-years (QALYs) for smokers and 0.14 QALYs for non-smokers. The incremental cost-effectiveness ratios for annual CT screening compared with no screening were $34 100/QALY for smokers and $125 400/QALY for non-smokers. Conclusions: Our analysis suggests that if early promising results for lung cancer screening hold, CT screening for lung cancer may increase survival and quality-adjusted survival among Hodgkin's lymphoma survivors, with a benefit and incremental cost-effectiveness ratio for smokers comparable to that of other recommended cancer screening strategies.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mdl023</identifier><identifier>PMID: 16500905</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Aged ; Antineoplastic agents ; Biological and medical sciences ; Carcinoma, Non-Small-Cell Lung - diagnostic imaging ; Carcinoma, Non-Small-Cell Lung - economics ; Carcinoma, Small Cell - diagnostic imaging ; Carcinoma, Small Cell - economics ; Computer Simulation ; Cost-Benefit Analysis ; cost-effectiveness ; decision analysis ; Decision Support Techniques ; Female ; Hematologic and hematopoietic diseases ; Hodgkin Disease - diagnostic imaging ; Hodgkin's lymphoma ; Humans ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Lung cancer ; Lung Neoplasms - diagnostic imaging ; Lung Neoplasms - economics ; Male ; Markov Chains ; Mass Screening - economics ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Pneumology ; Quality of Life ; Quality-Adjusted Life Years ; Risk Assessment ; Risk Factors ; second malignancies ; SEER Program ; Sensitivity and Specificity ; Survivors ; Tomography, X-Ray Computed - economics ; Tumors of the respiratory system and mediastinum</subject><ispartof>Annals of oncology, 2006-05, Vol.17 (5), p.785-793</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) May 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-d5ad6fc3811319cff73c6182bef9973a0d86723c79b9dd7984d72b5609d85b8d3</citedby><cites>FETCH-LOGICAL-c456t-d5ad6fc3811319cff73c6182bef9973a0d86723c79b9dd7984d72b5609d85b8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17860290$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16500905$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Das, P.</creatorcontrib><creatorcontrib>Ng, A. K.</creatorcontrib><creatorcontrib>Earle, C. C.</creatorcontrib><creatorcontrib>Mauch, P. M.</creatorcontrib><creatorcontrib>Kuntz, K. M.</creatorcontrib><title>Computed tomography screening for lung cancer in Hodgkin's lymphoma survivors: decision analysis and cost-effectiveness analysis</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>Background: Hodgkin's lymphoma patients have an elevated risk of developing lung cancer and may be targeted for lung cancer screening. We used a decision-analytic model to estimate the potential clinical benefits and cost-effectiveness of computed tomography (CT) screening for lung cancer in Hodgkin's lymphoma survivors. Materials and methods: We developed a Markov decision-analytic model to compare annual low-dose CT screening versus no screening in a hypothetical cohort of patients diagnosed with stage IA–IIB Hodgkin's lymphoma at age 25, with screening starting 5 years after initial diagnosis. We derived model parameters from published studies and the Surveillance, Epidemiology and End Results (SEER) Program, and assumed that stage-shift produces a survival benefit. Results: Annual CT screening increased survival by 0.64 years for smokers and 0.16 years for non-smokers. The corresponding benefits in quality-adjusted survival were 0.58 quality-adjusted life-years (QALYs) for smokers and 0.14 QALYs for non-smokers. The incremental cost-effectiveness ratios for annual CT screening compared with no screening were $34 100/QALY for smokers and $125 400/QALY for non-smokers. Conclusions: Our analysis suggests that if early promising results for lung cancer screening hold, CT screening for lung cancer may increase survival and quality-adjusted survival among Hodgkin's lymphoma survivors, with a benefit and incremental cost-effectiveness ratio for smokers comparable to that of other recommended cancer screening strategies.</description><subject>Aged</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Non-Small-Cell Lung - diagnostic imaging</subject><subject>Carcinoma, Non-Small-Cell Lung - economics</subject><subject>Carcinoma, Small Cell - diagnostic imaging</subject><subject>Carcinoma, Small Cell - economics</subject><subject>Computer Simulation</subject><subject>Cost-Benefit Analysis</subject><subject>cost-effectiveness</subject><subject>decision analysis</subject><subject>Decision Support Techniques</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hodgkin Disease - diagnostic imaging</subject><subject>Hodgkin's lymphoma</subject><subject>Humans</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - diagnostic imaging</subject><subject>Lung Neoplasms - economics</subject><subject>Male</subject><subject>Markov Chains</subject><subject>Mass Screening - economics</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Pneumology</subject><subject>Quality of Life</subject><subject>Quality-Adjusted Life Years</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>second malignancies</subject><subject>SEER Program</subject><subject>Sensitivity and Specificity</subject><subject>Survivors</subject><subject>Tomography, X-Ray Computed - economics</subject><subject>Tumors of the respiratory system and mediastinum</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9rFDEUx4NY7Hb16FWCoJ7GJpOdZOJNFu0WioIoSi8hkx_btDPJmDezdG_-6Z26QwtePL0H78N7fN8HoZeUvKdEslMdY4rmtLMtKdkTtKAVl0VNVvQpWhBZskJUbHWMTgCuCSFclvIZOqa8IkSSaoH-rFPXj4OzeEhd2mbdX-0xmOxcDHGLfcq4HafG6GhcxiHiTbLbmxDfAW73XX-VOo1hzLuwSxk-YOtMgJAi1lG3ewgwNRabBEPhvHdmCDsXHcDD_Dk68roF92KuS_Tj86fv601x8fXsfP3xojCrig-FrbTl3rCaUkal8V4ww2ldNs5LKZgmtuaiZEbIRlorZL2yomwqTqStq6a2bIneHvb2Of0eHQyqC2Bc2-ro0giKC0k4l-S_IJWSl3T66hK9_ge8TmOeYt0znDMmJZ2g4gCZnACy86rPodN5ryhR9wLVQaA6CJz4V_PSsemcfaRnYxPwZgY0GN36PIkJ8MiJmpPyb4z5cIDB3T7Mdb6ZojJRqc2vS1X-_ELE5TeuOLsDVlK26w</recordid><startdate>20060501</startdate><enddate>20060501</enddate><creator>Das, P.</creator><creator>Ng, A. K.</creator><creator>Earle, C. C.</creator><creator>Mauch, P. M.</creator><creator>Kuntz, K. M.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20060501</creationdate><title>Computed tomography screening for lung cancer in Hodgkin's lymphoma survivors: decision analysis and cost-effectiveness analysis</title><author>Das, P. ; Ng, A. K. ; Earle, C. C. ; Mauch, P. M. ; Kuntz, K. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-d5ad6fc3811319cff73c6182bef9973a0d86723c79b9dd7984d72b5609d85b8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Non-Small-Cell Lung - diagnostic imaging</topic><topic>Carcinoma, Non-Small-Cell Lung - economics</topic><topic>Carcinoma, Small Cell - diagnostic imaging</topic><topic>Carcinoma, Small Cell - economics</topic><topic>Computer Simulation</topic><topic>Cost-Benefit Analysis</topic><topic>cost-effectiveness</topic><topic>decision analysis</topic><topic>Decision Support Techniques</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hodgkin Disease - diagnostic imaging</topic><topic>Hodgkin's lymphoma</topic><topic>Humans</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - diagnostic imaging</topic><topic>Lung Neoplasms - economics</topic><topic>Male</topic><topic>Markov Chains</topic><topic>Mass Screening - economics</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Pneumology</topic><topic>Quality of Life</topic><topic>Quality-Adjusted Life Years</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>second malignancies</topic><topic>SEER Program</topic><topic>Sensitivity and Specificity</topic><topic>Survivors</topic><topic>Tomography, X-Ray Computed - economics</topic><topic>Tumors of the respiratory system and mediastinum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Das, P.</creatorcontrib><creatorcontrib>Ng, A. K.</creatorcontrib><creatorcontrib>Earle, C. C.</creatorcontrib><creatorcontrib>Mauch, P. M.</creatorcontrib><creatorcontrib>Kuntz, K. M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Das, P.</au><au>Ng, A. K.</au><au>Earle, C. C.</au><au>Mauch, P. M.</au><au>Kuntz, K. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Computed tomography screening for lung cancer in Hodgkin's lymphoma survivors: decision analysis and cost-effectiveness analysis</atitle><jtitle>Annals of oncology</jtitle><addtitle>Ann Oncol</addtitle><date>2006-05-01</date><risdate>2006</risdate><volume>17</volume><issue>5</issue><spage>785</spage><epage>793</epage><pages>785-793</pages><issn>0923-7534</issn><eissn>1569-8041</eissn><abstract>Background: Hodgkin's lymphoma patients have an elevated risk of developing lung cancer and may be targeted for lung cancer screening. We used a decision-analytic model to estimate the potential clinical benefits and cost-effectiveness of computed tomography (CT) screening for lung cancer in Hodgkin's lymphoma survivors. Materials and methods: We developed a Markov decision-analytic model to compare annual low-dose CT screening versus no screening in a hypothetical cohort of patients diagnosed with stage IA–IIB Hodgkin's lymphoma at age 25, with screening starting 5 years after initial diagnosis. We derived model parameters from published studies and the Surveillance, Epidemiology and End Results (SEER) Program, and assumed that stage-shift produces a survival benefit. Results: Annual CT screening increased survival by 0.64 years for smokers and 0.16 years for non-smokers. The corresponding benefits in quality-adjusted survival were 0.58 quality-adjusted life-years (QALYs) for smokers and 0.14 QALYs for non-smokers. The incremental cost-effectiveness ratios for annual CT screening compared with no screening were $34 100/QALY for smokers and $125 400/QALY for non-smokers. Conclusions: Our analysis suggests that if early promising results for lung cancer screening hold, CT screening for lung cancer may increase survival and quality-adjusted survival among Hodgkin's lymphoma survivors, with a benefit and incremental cost-effectiveness ratio for smokers comparable to that of other recommended cancer screening strategies.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>16500905</pmid><doi>10.1093/annonc/mdl023</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antineoplastic agents Biological and medical sciences Carcinoma, Non-Small-Cell Lung - diagnostic imaging Carcinoma, Non-Small-Cell Lung - economics Carcinoma, Small Cell - diagnostic imaging Carcinoma, Small Cell - economics Computer Simulation Cost-Benefit Analysis cost-effectiveness decision analysis Decision Support Techniques Female Hematologic and hematopoietic diseases Hodgkin Disease - diagnostic imaging Hodgkin's lymphoma Humans Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Lung cancer Lung Neoplasms - diagnostic imaging Lung Neoplasms - economics Male Markov Chains Mass Screening - economics Medical sciences Middle Aged Pharmacology. Drug treatments Pneumology Quality of Life Quality-Adjusted Life Years Risk Assessment Risk Factors second malignancies SEER Program Sensitivity and Specificity Survivors Tomography, X-Ray Computed - economics Tumors of the respiratory system and mediastinum |
| title | Computed tomography screening for lung cancer in Hodgkin's lymphoma survivors: decision analysis and cost-effectiveness analysis |
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