Yuki Tomonaga1, Kevin Ten Haaf2, Thomas Frauenfelder3, Malcolm Kohler4, Roger D Kouyos5, Mohaned Shilaih5, Matthias Lorez6, Harry J de Koning2, Matthias Schwenkglenks1, Milo A Puhan7. 1. Epidemiology, Biostatistics und Prevention Institute (EBPI), University of Zurich, 8001 Zurich, Switzerland. 2. Department of Public Health, Erasmus MC - University Medical Center Rotterdam, 3015 CE Rotterdam, The Netherlands. 3. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8091 Zurich, Switzerland. 4. Pulmonary Division, University Hospital Zurich, 8091 Zurich, Switzerland. 5. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland; Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland. 6. National Institute for Cancer Epidemiology and Registration, 8001 Zurich, Switzerland. 7. Epidemiology, Biostatistics und Prevention Institute (EBPI), University of Zurich, 8001 Zurich, Switzerland. Electronic address: miloalan.puhan@uzh.ch.
Abstract
OBJECTIVES: In Europe, there is uncertainty about the potential effects and cost-effectiveness of low dose computed tomography screening for lung cancer and about the applicability of results of North American studies. We aimed to estimate the effects and cost-effectiveness of lung cancer screening in a population-based setting in Switzerland where the smoking prevalence is high. MATERIALS AND METHODS: The MIcrosimulation Screening ANalysis-Lung (MISCAN) model was adapted using country specific input parameters regarding lung cancer epidemiology, smoking behaviours, and treatment costs. The effects and costs of 648 screening scenarios with different screening start and stop ages, smoking eligibility criteria, and screening intervals were examined from a public healthcare system perspective across a lifetime horizon in a cohort born between 1935 and 1965. RESULTS: All screening scenarios showed an increase in the total number of detected lung cancer cases and a decrease in lung cancer mortality. On the efficiency frontier, 15 of 27 scenarios showed incremental cost-effectiveness ratios below € 50,000 per life year gained. These scenarios reduced lung cancer mortality by 6-15% while increasing incidence of lung cancer diagnoses by 2-6%. CONCLUSION: These results suggest that lung cancer screening may be cost-effective in Switzerland, a high-income, European country with high smoking prevalence.
OBJECTIVES: In Europe, there is uncertainty about the potential effects and cost-effectiveness of low dose computed tomography screening for lung cancer and about the applicability of results of North American studies. We aimed to estimate the effects and cost-effectiveness of lung cancer screening in a population-based setting in Switzerland where the smoking prevalence is high. MATERIALS AND METHODS: The MIcrosimulation Screening ANalysis-Lung (MISCAN) model was adapted using country specific input parameters regarding lung cancer epidemiology, smoking behaviours, and treatment costs. The effects and costs of 648 screening scenarios with different screening start and stop ages, smoking eligibility criteria, and screening intervals were examined from a public healthcare system perspective across a lifetime horizon in a cohort born between 1935 and 1965. RESULTS: All screening scenarios showed an increase in the total number of detected lung cancer cases and a decrease in lung cancer mortality. On the efficiency frontier, 15 of 27 scenarios showed incremental cost-effectiveness ratios below € 50,000 per life year gained. These scenarios reduced lung cancer mortality by 6-15% while increasing incidence of lung cancer diagnoses by 2-6%. CONCLUSION: These results suggest that lung cancer screening may be cost-effective in Switzerland, a high-income, European country with high smoking prevalence.
Authors: Matthijs Oudkerk; ShiYuan Liu; Marjolein A Heuvelmans; Joan E Walter; John K Field Journal: Nat Rev Clin Oncol Date: 2020-10-12 Impact factor: 66.675
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Authors: Andrea Gini; Nicolien T van Ravesteyn; Erik E L Jansen; Eveline A M Heijnsdijk; Carlo Senore; Ahti Anttila; Dominika Novak Mlakar; Piret Veerus; Marcell Csanádi; Nadine Zielonke; Sirpa Heinävaara; György Széles; Nereo Segnan; Harry J de Koning; Iris Lansdorp-Vogelaar Journal: Prev Med Rep Date: 2021-04-30