Version 1
: Received: 23 May 2024 / Approved: 24 May 2024 / Online: 24 May 2024 (10:11:01 CEST)
How to cite:
Rajabi, T.; Szilberhorn, L.; Győrbíró, D.; Tatár, M.; Vokó, Z.; Nagy, B. Cost-Effectiveness of Lung Cancer Screening with Low-Dose Computed Tomography: Comparing the NLST and NELSON Trial Protocols. Preprints2024, 2024051596. https://doi.org/10.20944/preprints202405.1596.v1
Rajabi, T.; Szilberhorn, L.; Győrbíró, D.; Tatár, M.; Vokó, Z.; Nagy, B. Cost-Effectiveness of Lung Cancer Screening with Low-Dose Computed Tomography: Comparing the NLST and NELSON Trial Protocols. Preprints 2024, 2024051596. https://doi.org/10.20944/preprints202405.1596.v1
Rajabi, T.; Szilberhorn, L.; Győrbíró, D.; Tatár, M.; Vokó, Z.; Nagy, B. Cost-Effectiveness of Lung Cancer Screening with Low-Dose Computed Tomography: Comparing the NLST and NELSON Trial Protocols. Preprints2024, 2024051596. https://doi.org/10.20944/preprints202405.1596.v1
APA Style
Rajabi, T., Szilberhorn, L., Győrbíró, D., Tatár, M., Vokó, Z., & Nagy, B. (2024). Cost-Effectiveness of Lung Cancer Screening with Low-Dose Computed Tomography: Comparing the NLST and NELSON Trial Protocols. Preprints. https://doi.org/10.20944/preprints202405.1596.v1
Chicago/Turabian Style
Rajabi, T., Zoltán Vokó and Balázs Nagy. 2024 "Cost-Effectiveness of Lung Cancer Screening with Low-Dose Computed Tomography: Comparing the NLST and NELSON Trial Protocols" Preprints. https://doi.org/10.20944/preprints202405.1596.v1
Abstract
We aimed to directly compare the cost-effectiveness of the NELSON and NLST screening protocols, two trials influencing lung cancer screening implementation internationally. A decision-analytic model analyzing the cost-effectiveness of the NELSON protocols was manipulated to reflect the protocols of the NLST, while maintaining features specific to the Hungarian healthcare setting. In the NELSON protocol, there are three possible outcomes to the initial round of screening: positive, negative, or indeterminate, indicating an uncertain degree of suspicion for lung cancer. This pro-tocol differs from the NLST protocol, in which the only possible screening outcomes are positive or negative, with no indeterminate option. The NLST pathway for smokers aged 55-74 resulted in a 43 € increase in total average lifetime costs compared to the Hungarian screening pathway and re-sulted in a lifetime gain of 0.006 QALYs. The incremental costs and QALYs yield an ICER of 7875 €/QALY. Our results demonstrate that assigning any suspicious LDCT screen as a positive result (NLST protocol) rather than indeterminate (NELSON protocol) can yield a slight QALY gain that is worth the additional use of resources according to Hungary’s willingness to pay threshold. Our study provides insight on the cost-effectiveness, advantages, and disadvantages of various LDCT screening protocols for lung cancer and can assist other countries as they implement their screening programs.
Public Health and Healthcare, Public Health and Health Services
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
