Analysis of high-risk lung cancer screening shows that screening is cost-effective and may offer cost savings if noncurative treatment costs continue to rise, according to new research published in the Journal of Thoracic Oncology (June 2017; doi:10.1016/j.jtho.2017.04.021).
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Health care systems are having difficulty affording lung cancer drugs and improving access to new medicines, thus making prevention and early detection increasingly important. Early diagnosis of smoking-related diseases could improve length and quality of life. However, there are currently no national lung cancer screening programs, due to concerns that the benefit in terms of life improvement are not able to offset the financial burden of screening.
Sonya Cressman, MD, The Canadian Centre for Applied Research in Cancer Control (Canada), and colleagues analyzed patient data from two large lung cancer screening trials: the National Lung Cancer Screening Trial (NLST) and the Pan-Canadian Early Detection of Lung Cancer Study (PanCan). Researchers created an economic model that simulated the costs and benefits of a lung cancer screening program for patients with at least a 2% chance of developing lung cancer within six years (high-risk).
Results of the assessment showed that limiting screening efforts to high-risk patients alone could reduce the total of patients who need to be screened by 80%. The cost of screening was calculated at $20,724 per year of life saved. Compared to conventional cancer interventions in national health care (approximately $100,000), high-risk screening would be significantly more cost effective.
Furthermore, researchers suggest that combining lung cancer screening for multiple conditions in an attempt to stop smoking and managed the treatment of non-cancer related heart and lung disease (such as chronic obstructive pulmonary disease) could continue to make screening more cost-effective.
"We need to think about how we manage lung cancer and focus on more economically viable strategies, including prevention and screening. Screening those at a high risk gives us the chance to prevent and treat a range of tobacco-related illnesses, and could also offer access to care for individuals who could be otherwise stigmatized or segregated from receiving treatment," said Dr Cressman in an interview (June 29, 2017).—Zachary Bessette
