Cost-effectiveness of implementing computed tomography screening for lung cancer in Taiwan

Szu Chun Yang, Wu Wei Lai, Chien Chung Lin, Wu Chou Su, Li Jung Ku, Jing Shiang Hwang, Jung Der Wang

研究成果: Article同行評審

48 引文 斯高帕斯(Scopus)

摘要

Background A screening program for lung cancer requires more empirical evidence. Based on the experience of the National Lung Screening Trial (NLST), we developed a method to adjust lead-time bias and quality-of-life changes for estimating the cost-effectiveness of implementing computed tomography (CT) screening in Taiwan. Methods The target population was high-risk (≥30 pack-years) smokers between 55 and 75 years of age. From a nation-wide, 13-year follow-up cohort, we estimated quality-adjusted life expectancy (QALE), loss-of-QALE, and lifetime healthcare expenditures per case of lung cancer stratified by pathology and stage. Cumulative stage distributions for CT-screening and no-screening were assumed equal to those for CT-screening and radiography-screening in the NLST to estimate the savings of loss-of-QALE and additional costs of lifetime healthcare expenditures after CT screening. Costs attributable to screen-negative subjects, false-positive cases and radiation-induced lung cancer were included to obtain the incremental cost-effectiveness ratio from the public payer's perspective. Results The incremental costs were US$22,755 per person. After dividing this by savings of loss-of-QALE (1.16 quality-adjusted life year (QALY)), the incremental cost-effectiveness ratio was US$19,683 per QALY. This ratio would fall to US$10,947 per QALY if the stage distribution for CT-screening was the same as that of screen-detected cancers in the NELSON trial. Conclusions Low-dose CT screening for lung cancer among high-risk smokers would be cost-effective in Taiwan. As only about 5% of our women are smokers, future research is necessary to identify the high-risk groups among non-smokers and increase the coverage.

原文English
頁(從 - 到)183-191
頁數9
期刊Lung Cancer
108
DOIs
出版狀態Published - 2017 6月 1

All Science Journal Classification (ASJC) codes

  • 腫瘤科
  • 肺和呼吸系統醫學
  • 癌症研究

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