Abstract：
UNASSIGNED: This study aimed to evaluate the cost-effectiveness of lung cancer screening (LCS) with volume-based low-dose computed tomography (CT) versus no screening for an asymptomatic high-risk population in the United Kingdom (UK), utilising the long-term insights provided by the NELSON study, the largest European randomized control trial investigating LCS.
UNASSIGNED: A cost-effectiveness analysis was conducted using a decision tree and a state-transition Markov model to simulate the identification, diagnosis, and treatments for a lung cancer high-risk population, from a UK National Health Service (NHS) perspective. Eligible participants underwent annual volume CT screening and were compared to a cohort without the option of screening. Screen-detected lung cancers, costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) were predicted.
UNASSIGNED: Annual volume CT screening of 1.3 million eligible participants resulted in 96,474 more lung cancer cases detected in early stage, and 73,825 fewer cases in late stage, leading to 53,732 premature lung cancer deaths averted and 421,647 QALYs gained, compared to no screening. The ICER was £5,455 per QALY. These estimates were robust in sensitivity analyses.
UNASSIGNED: Lack of long-term survival data for lung cancer patients; deficiency in rigorous micro-costing studies to establish detailed treatment costs inputs for lung cancer patients.
UNASSIGNED: Annual LCS with volume-based low-dose CT for a high-risk asymptomatic population is cost-effective in the UK, at a threshold of £20,000 per QALY, representing an efficient use of NHS resources with substantially improved outcomes for lung cancer patients, as well as additional societal and economic benefits for society as a whole. These findings advocate evidence-based decisions for the potential implementation of a nationwide LCS in the UK.
UNASSIGNED: A cost-effectiveness analysis was conducted using a decision tree and a state-transition Markov model to simulate the identification, diagnosis, and treatments for a lung cancer high-risk population, from a UK National Health Service (NHS) perspective. Eligible participants underwent annual volume CT screening and were compared to a cohort without the option of screening. Screen-detected lung cancers, costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) were predicted.
UNASSIGNED: Annual volume CT screening of 1.3 million eligible participants resulted in 96,474 more lung cancer cases detected in early stage, and 73,825 fewer cases in late stage, leading to 53,732 premature lung cancer deaths averted and 421,647 QALYs gained, compared to no screening. The ICER was £5,455 per QALY. These estimates were robust in sensitivity analyses.
UNASSIGNED: Lack of long-term survival data for lung cancer patients; deficiency in rigorous micro-costing studies to establish detailed treatment costs inputs for lung cancer patients.
UNASSIGNED: Annual LCS with volume-based low-dose CT for a high-risk asymptomatic population is cost-effective in the UK, at a threshold of £20,000 per QALY, representing an efficient use of NHS resources with substantially improved outcomes for lung cancer patients, as well as additional societal and economic benefits for society as a whole. These findings advocate evidence-based decisions for the potential implementation of a nationwide LCS in the UK.
摘要：
目的本研究旨在评估在英国（UK）使用基于体积的低剂量计算机断层扫描（CT）进行肺癌筛查（LCS）与不进行无症状高危人群筛查的成本效益。利用尼尔森研究提供的长期见解，欧洲最大的研究LCS的随机对照试验.方法采用决策树和状态转移马尔可夫模型进行成本-效果分析,诊断,以及对肺癌高危人群的治疗，从英国国家卫生服务（NHS）的角度来看。符合条件的参与者接受了年度容积CT筛查，并与没有筛查选项的队列进行比较。筛查检测到的肺癌，成本,质量调整生命年(QALYs)，并对增量成本效益比(ICER)进行了预测。结果每年对130万符合条件的参与者进行CT筛查，导致早期发现的肺癌病例增加了96,474例，后期减少73,825例,导致53,732例肺癌过早死亡，获得421,647例QALY，与没有筛查相比。ICER为每QALY5455英镑。这些估计在敏感性分析中是稳健的。局限性缺乏肺癌患者的长期生存数据；缺乏严格的微观成本研究，无法为肺癌患者建立详细的治疗成本投入。结论在英国，对高风险无症状人群进行基于体积的低剂量CT的年度LCS具有成本效益，每个QALY的门槛为20,000英镑，代表有效利用NHS资源，大大改善肺癌患者的预后，以及整个社会的额外社会和经济利益。国家LCS强烈建议在英国实施。
