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Review
. 2015 Mar;30(2):79-87.
doi: 10.1097/RTI.0000000000000136.

Computed tomography screening for lung cancer in the National Lung Screening Trial: a cost-effectiveness analysis

William C Black  1
Affiliations
Review

Computed tomography screening for lung cancer in the National Lung Screening Trial: a cost-effectiveness analysis

William C Black. J Thorac Imaging. 2015 Mar.

Erratum in

Abstract

The National Lung Screening Trial (NLST) demonstrated that screening with low-dose CT versus chest radiography reduced lung cancer mortality by 16% to 20%. More recently, a cost-effectiveness analysis (CEA) of CT screening for lung cancer versus no screening in the NLST was performed. The CEA conformed to the reference-case recommendations of the US Panel on Cost-Effectiveness in Health and Medicine, including the use of the societal perspective and an annual discount rate of 3%. The CEA was based on several important assumptions. In this paper, I review the methods and assumptions used to obtain the base case estimate of $81,000 per quality-adjusted life-year gained. In addition, I show how this estimate varied widely among different subsets and when some of the base case assumptions were changed and speculate on the cost-effectiveness of CT screening for lung cancer outside the NLST.

Trial registration: ClinicalTrials.gov NCT00047385.

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Figures

FIGURE 1
FIGURE 1
Scatterplot of incremental QALY and incremental cost obtained by 10,000 bootstrap samplings.
FIGURE 2
FIGURE 2
Cost-effectiveness acceptability curve (CEAC). As the cost-effectiveness threshold increases, the probability that CT screening for lung cancer is cost-effective also increases.
FIGURE 3
FIGURE 3
ICER of CT screening for lung cancer versus lung cancer risk relative to participants in NLST.
See this image and copyright information in PMC

References

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