Potential cost-effectiveness of one-time screening for lung cancer (LC) in a high risk cohort

被引:66
作者
Marshall, D
Simpson, KN
Earle, CC
Chu, CW
机构
[1] Bayer Diagnost, Emeryville, CA USA
[2] Med Univ S Carolina, Charleston, SC 29425 USA
[3] Dana Farber Canc Inst, Boston, MA 02115 USA
关键词
cost-effectiveness analysis; lung cancer screening; helical computed-tomography; Early Lung Cancer Action Project;
D O I
10.1016/S0169-5002(00)00239-7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The development of low-dose helical computed-tomography (CT) scanning to detect nodules as small as a few mm has sparked renewed interest in lung cancer (LC) screening. The objective of this study was to assess the potential health effects and cost-effectiveness of a one-time low-dose helical CT scan to screen for LC. We created a decision analysis model using baseline results from the Early Lung Cancer Action Project (ELCAP); Surveillance, Epidemiology and End Results (SEER) registry public-use database: screening program costs estimated from 1999 Medicare reimbursement rates: and annual costs of managing cancer and non-cancer patients from Riley et al. (1995) [Med Care 1995:33(8):828-841] and Taplin et al. (1995) [J Nail Cancer Inst 1995:87(6):417-26], The main outcome measures included years of life, cost estimates of baseline diagnostic screening and Follow up, and cost-effectiveness of screening. We found that in a very high-risk cohort (LC prevalence of 2.7%) of patients between 60 and 74 years of age. a one-time screen appears to be cost-effective at $5940 per life year saved. In a lower risk general population of smokers (LC prevalence of 0.7%), a one-time screen appears to be cost-effective at $23 100 per life year. Even when a lead-time bias of 1 year is incorporated into the model for a low risk population, the cost-effectiveness is estimated at $58 183 per life year. Based on the assumptions embedded in this model, one-time screening of elderly high-risk patients for LC appears to be cost-effective. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:227 / 236
页数:10
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