Screening for and Treating Early-Stage Lung Cancer Is Less Costly Than Treating Late-Stage Disease
A new study found that the average cost to screen high-risk individuals for lung cancer with low-dose computed tomography (CT) plus the average cost of curative-intent treatment is lower than the average cost to treat advanced-stage lung cancer, which quite rarely results in a cure. The findings by Cressman et al were published in the Journal of Thoracic Oncology.
The National Lung Cancer Screening Trial (NLST) previously showed that low-dose CT screening of people at high-risk for lung cancer reduces lung cancer mortality by 20%, a finding that led many organizations, including the United States Preventive Services Task Force (USPSTF), to recommend low-dose CT screening for these individuals. The 5-year survival rate for early-stage lung cancer is 54%, compared with 4% for late-stage disease. It is thought that if lung cancer is detected at an early stage with screening then it can be cured, resulting in a significant reduction in lung cancer mortality—and in the need for expensive and toxic treatments that seldom result in cure. However, in the United States, 8.6 million people meet the high-risk criteria, which could equate to a significant screening cost.
Study Details
The Pan-Canadian Early Detection Study prospectively examined the costs for the resources used to screen annually, treat (if necessary), and follow for 2 years 2,059 participants who had a 2% or greater risk of developing lung over 3 years as determined by a Web-based lung cancer risk prediction tool.
Over the entire study period, the average cost per person for at least two annual low-dose CT screens and all necessary follow-up scans was $453 for individuals without lung cancer vs $2,248 for those with lung cancer. The mean per-person cost for diagnostic workup, curative intent surgical treatment, and 2 years of follow-up was $33,344 for those diagnosed with lung cancer. In comparison, the cost for treating advanced-stage lung cancer with chemotherapy, radiotherapy, or supportive care alone was $47,792.
“The number of deaths that potentially could be prevented and the number of life-years gained with lung cancer screening using low-dose CT is greater than any new treatment modality offered over the last 2 decades,” the study authors wrote. Additionally, “if expensive targeted therapies become widespread in the treatment of advanced, inoperable lung cancer, a screening program could potentially become cost-saving while at the same time improving patient outcomes.”
The authors also noted that “our risk prediction tool has been found to have 11.9% greater sensitivity in identifying those who would be diagnosed with lung cancer in the 6 years of follow-up compared with the NLST criteria, thus reducing the number of people that needed to be screened to detect lung cancer and improving cost-effectiveness.”
Sonya Cressman, PhD, MBA, of the BC Cancer Agency, is the corresponding author for the Journal of Thoracic Oncology article.
For full disclosures of the study authors, visit journals.lww.com/jto.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
