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Lung cancer screening with low-dose computed tomography: National expenditures and cost-effectiveness

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Zeng, X and Zhou, Z and Lou, X and Liu, Q, Lung cancer screening with low-dose computed tomography: National expenditures and cost-effectiveness, Frontiers in Public Health, 10 Article 977550. ISSN 2296-2565 (2022) [Refereed Article]


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Copyright Statement

Copyright 2022 Zeng, Zhou, Luo and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

DOI: doi:10.3389/fpubh.2022.977550

Abstract

Objective:To compare the cost-effectiveness of undertaking low-dose computed tomography (LDCT) screening for early detection of lung cancer (LC) with different frequencies within the healthcare system of China, and estimate the additional national healthcare expenditure and five-year LC mortality associated with different screening frequencies.

Material and methods:A Markov model was established using national LC epidemiological data from the Chinese Center for Disease Control and Prevention, demographic data from the Chinese Statistical Yearbook, and cost and effectiveness data mainly from the Cancer Screening Program in China. The model included thirty sex-specific screening strategies, which were classified by initial screening age (30, 35, 40, 45, and 50), and screening intervals (intervals at single time point, 1, 2, 5, 10, and 20 years). The main model outputs were incremental cost-effectiveness ratios (ICERs), additional national healthcare expenditure and five-year LC mortality.

Results:The ICERs for LDCT screening strategies vs. non-screening strategy ranged from $16,086 per quality-adjusted life-year (QALY) to $3,675,491 per QALY in the male cohort, and from $36,624 per QALY to $5,943,556 per QALY in the female cohort. The annual increment national healthcare expenditures related to LDCT screening were varied from $0.25 to $13.39 billion, with the lower cost in the cohort with older screening ages and lower screening frequencies. More frequent screening with LDCT was associated with a greater reduction in LC death: an annual LDCT screening was linked to an estimated reduction in five-year LC death by 27.27-29.07%, while a one-off screening was linked to a reduction by 5.56-5.83%.

Conclusion:Under a willingness-to-pay (WTP) threshold of three times the Chinese gross domestic product (GDP) per capita (US $37,654), annual screening with an initiating age at 50 was most cost-effective in both male and female cohorts. By taking into account both the national healthcare expenditures and the effect of LDCT screening, our study results support undertaking LDCT screening annually from 50 years old in general populations.

Item Details

Item Type:Refereed Article
Keywords:lung cancer, LDCT, cost-effectiveness, healthcare expenditures, five-year LC mortality, China
Research Division:Economics
Research Group:Applied economics
Research Field:Health economics
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Health policy evaluation
UTAS Author:Zhou, Z (Dr Zhen Zhou)
ID Code:153652
Year Published:2022
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-09-29
Last Modified:2022-12-05
Downloads:4 View Download Statistics

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