From the Guidelines
The cost per year of life saved for lung cancer CT screening is approximately $81,000 per quality-adjusted life year gained, as reported in the most recent and highest quality study 1. This cost-effectiveness ratio is considered reasonable compared to other accepted medical interventions. The cost variation depends on several factors including:
- Screening frequency (usually annual)
- The specific population being screened
- Healthcare system efficiency
- Downstream costs from follow-up procedures for false positives Low-dose computed tomography (LDCT) screening for high-risk individuals has been shown to reduce lung cancer mortality by about 20-24% 1. While the upfront costs of implementing screening programs are substantial, they are offset by the benefits of detecting lung cancer at earlier, more treatable stages, which improves survival outcomes and may reduce the costs associated with treating advanced disease. The cost-effectiveness improves when screening is targeted to the highest-risk populations and when efficient protocols are in place to manage incidental findings 1. It's worth noting that the cost-effectiveness of LDCT screening could vary substantially as it is implemented in real-world settings, depending on patient selection, false-positive rate, and rates of invasive procedures. However, based on the most recent evidence, the cost per year of life saved for lung cancer CT screening is a reasonable investment in terms of morbidity, mortality, and quality of life outcomes.
From the Research
Cost Per Year of Life Saved for Lung Cancer CT Screening
- The cost per year of life saved for lung cancer CT screening varies across studies, with estimates ranging from approximately $1,900 to $96,700 per year of life saved 2, 3, 4.
- A study published in 2003 estimated the incremental cost-effectiveness ratio of a single baseline low-dose CT scan to be $2,500 per year of life saved 2.
- Another study published in 2019 found that the incremental cost-effectiveness ratios for lung cancer screening strategies averaged $49,200, $68,600, and $96,700 per quality-adjusted life-year (QALY) for the NLST, CMS, and USPSTF strategies, respectively 3.
- An actuarial analysis published in 2014 estimated the cost per life-year saved for LDCT lung cancer screening in Medicare beneficiaries to be less than $19,000 4.
- Other studies have focused on the cost-effectiveness of lung cancer screening in terms of the cost per 5-year survivor, with estimates suggesting that proactive CT screening may be more cost-effective than symptomatic tumor identification 5.
Factors Influencing Cost-Effectiveness
- The cost-effectiveness of lung cancer CT screening is influenced by various factors, including the screening strategy, patient population, and assumptions about the natural history of lung cancer 2, 3, 4.
- The likelihood of overdiagnosis and the potential for lead-time bias can also impact the cost-effectiveness of lung cancer screening 2, 3.
- The use of low-dose CT scans and the implementation of effective nodule management protocols can help improve the cost-effectiveness of lung cancer screening 6.