CT lung cancer screening combined with smoking cessation is worth expense

por Lauren Dubinsky, Senior Reporter | October 18, 2017
CT X-Ray
$14,000 per quality-adjusted
life-years gained
Smoking cessation interventions are needed to get the most out of low-dose CT lung cancer screening programs, according to a new study presented today at the World Conference on Lung Cancer in Japan.

These interventions were shown to decrease mortality rates while remaining relatively cost-effective.

"We evaluated the cost-effectiveness of LDCT and of smoking cessation integrated into screening, because in publicly funded health care systems, such as the Canadadian, evidence of cost-effectiveness has become a requirement for the adoption and funding of new health care interventions," Dr. William Evans, lead researcher, told HCB News.
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The research team at McMaster University in Canada used a microsimulation model called OncoSim-LC to compare screening with and without cessation interventions over a 20-year time period. They based cost-effectiveness on a lifetime horizon, health system perspective and 1.5 percent discount rate.

They found that adding smoking cessation interventions to an organized LDCT lung cancer screening program could cost $14,000 per quality-adjusted life-years gained in Canadian dollars. It would also result in fewer deaths.

Another Canadian study that was published in the Journal of Thoracic Oncology in June also proved that smoking cessation interventions make CT lung cancer screening more cost-effective. They found that the best strategy is combining CT screening for multiple conditions with efforts to stop smoking and manage the treatment of non-cancer heart and lung disease.

The researchers for the new study cautioned that it’s still unclear how these joint programs would pan out in clinical practice. More research is needed to determine the precise economic requirements, ensure patient adherence to both interventions and evaluate other logistical trade-offs.

"Some LDCT screening programs in the USA do include smoking cessation but this is not universal," said Evans. "Pilot studies being done in Canada do incorporate smoking cessation in an effort to understand how to optimally implement LDCT with smoking cessation."

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