4.5 Article

Cost Utility Analysis of a Pilot Study for the Korean Lung Cancer Screening Project

Journal

CANCER RESEARCH AND TREATMENT
Volume 54, Issue 3, Pages 728-736

Publisher

KOREAN CANCER ASSOCIATION
DOI: 10.4143/crt.2021.480

Keywords

Cost-benefit analysis; Lung neoplasms; Mass screening; Markov chains

Categories

Funding

  1. National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea [1720310]

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This study evaluates the cost utility of the Korean Lung Cancer Screening Project. The results show that annual low-dose computed tomography screening is cost-effective for high-risk populations.
Purpose The aim of this study was to evaluate the cost utility of a pilot study of Korean Lung Cancer Screening Project. Materials and Methods We constructed a Markov model consisting of 26 states based on the natural history of lung cancer according to the Surveillance, Epidemiology, and End Results summary stage (localized, regional, distant). In the base case, people aged 55-74 years were under consideration for annual screening. Costs and quality-adjusted life years were simulated to calculate the incremental cost utility ratio. Sensitivity analyses were performed on the uncertainty associated with screening target ages, stage distribution, cost, utility, mortality, screening duration, and discount rate. Results The base case (US$25,383 per quality-adjusted life year gained) was cost-effective compared to the scenario of no screening and acceptable considering a willingness-to-pay threshold of US$27,000 per quality-adjusted life years gained. In terms of the target age of screening, the age between 60 and 74 years was the most cost-effective. Lung cancer screening was still cost-effective in the sensitivity analyses on the cost for treatment, utility, mortality, screening duration, and less than 5% discount rates, although the result was sensitive to a rise in positive rates or variation of stage distribution. Conclusion Our results showed the cost-effectiveness of annual low-dose computed tomography screening for lung cancer in high-risk populations.

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