Screening for lung cancer with chest computerized tomography:Is it cost efficient?

• 作者: Janusz Kowalewski Malgorzata Kanarkiewicz Tomasz Jaroslaw Szczesny
• 来源期刊: 世界呼吸病学杂志
• 学科: 医学
• 关键词: LUNG cancer NON-SMALL cell LUNG cancers SCREENING COST-EFFECTIVENESS COMPUTERIZED TOMOGRAPHY Low-dose COMPUTERIZED TOMOGRAPHY
• 年，卷（期）: 2015,（2）
• 页码范围: 160-165
• 页数: 6页
• 分类号: R

摘要

Despite lung cancer(LC)screening by low-dose computerized tomography(LDCT)gaining many proponents worldwide,for many years it was not recognized as a life-prolonging and cost-effective procedure,until recently.Prospective observational studies had not been able to prove that this screening prolongs survival,but they helped to specify the inclusion and exclusion criteria.Long-awaited results of a prospective,randomized trial finally provided the evidence that LC screening with LDCT can prolong survival of the screened population.Several costeffectiveness analyses were performed to justify mass introduction of this screening.Results of these analyses are equivocal,although conclusions highly depend upon inclusion and exclusion criteria,methods of analysis and prices of medical procedures which differ between countries as well as the incidence of other pulmonary nodules,especially tuberculosis.Therefore,costeffectiveness analysis should be performed separately for every country.Cost-effectiveness depends especially upon the rate of false-positive results and the rate of unnecessary diagnostic,screening and treatment procedures.To ensure high cost-effectiveness,LC screening should be performed in accordance with screening protocol,in dedicated screening centers equipped with nodule volume change analysis,or as a prospective non-randomized trial,to ensure compliance with the inclusion and exclusion criteria.To ensure high cost-effectiveness of LC screening,future research should concentrate on determination of highrisk groups and further specifying the inclusion and exclusion criteria.