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According to a report presented to the International Association for the Study of Lung Cancer, lung cancer screening using low-dose computed tomography would prevent more than 18,000 premature deaths from lung cancer at an estimated cost of $937 million. euros if half of the eligible population were screened. World Conference on Lung Cancer 2022.
Lung cancer is the leading cause of cancer-related death, accounting for 1.8 million deaths worldwide and nearly 400,000 deaths in Europe in 2020. Volume computed tomography (CT) screening has the potential to address this heavy disease burden through early detection of lung cancer, which then leads to reduced mortality in high-risk populations. However, concerns persist about the economic implications of implementing national lung cancer screening (LCS) programs.
Studies have indicated that LCS with low radiation dose volume CT is cost-effective in several European countries, but there is little evidence to demonstrate the financial consequences of implementing a screening program.
To do this, Xuanqi Pan of the Institute for Diagnostic Accuracy, the Netherlands, and colleagues developed a budget impact model based on the NELSON study and applied it to 28 European countries.
First reported at the 2018 IASLC World Conference on Lung Cancer, the NELSON study was a population-based controlled trial involving 15,792 individuals, who were randomized 1:1 to the study or in the control arm. Participants in the study arm were offered CT examinations at baseline, one, three, and five and a half years after randomization. No screening was offered to participants in the control arm. Participant records were linked to national registries with 100 percent coverage for cancer diagnosis (Netherlands Cancer Registry), date of death (Genealogy Center), and cause of death (Statistics from the Netherlands). A panel of experts reviewed 65 percent of the cases. The follow-up period included a minimum of 10 years, unless death, for 93.7 percent of enrolled participants.
Dr. Pan and his team applied this model to demonstrate the financial and health-related consequences of implementing a national LCS program, for 28 European countries, compared to the current standard of care (without screening) . The eligible population meeting the NELSON inclusion criteria underwent LCS with volumetric nodule management according to the NELSON protocol. The results of the NELSON screening were used in the model.
The screening population would amount to nearly 21 million, which would mean 18,169 premature deaths from lung cancer averted with a budget impact of €937.3 million, assuming an uptake rate of 50% in Europe. The cost per premature death from lung cancer averted was 51,588 euros and the cost per screening participant was 45 euros. Sensitivity analysis showed that the main influential parameters that affected the total budget impact were CT unit costs, stage I and stage IV treatment costs.
“Lung cancer screening in 28 European countries with volume-based low-dose CT would prevent more than 18,000 premature deaths from lung cancer, at a budget of approximately €937 million, if uptake of 50 % in the eligible population,” said Dr. Pan reported. “LCS implementation can provide substantive clinical benefits at a reasonable budget.”
The NELSON assay protocol is more sensitive than the NLST and may increase the benefits of lung cancer screening
Provided by the International Association for the Study of Lung Cancer
Citation: Budget Impact Analysis Shows NELSON Screening Model Would Save More Than 18,000 Premature Lung Cancer Deaths (2022, August 8) Retrieved August 8, 2022 from
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