A groundbreaking study reveals that tailored lung cancer screening strategies significantly enhance cost-effectiveness in China, offering better outcomes for both smokers and nonsmokers.
Advanced Screening Model Enhances Precision
China carries the highest global burden of lung cancer, with an alarming 40% of cases occurring in individuals who have never smoked. Researchers developed the Chinese NCC-LCm2021 model using data from a nationwide population to pinpoint high-risk individuals among both smokers and nonsmokers. This model aims to refine screening approaches beyond the established low-dose computed tomography (LDCT), which, despite its benefits in reducing mortality, poses potential adverse effects.
Cost-Effectiveness Analysis Unveils Optimal Strategies
The study employed a calibrated Markov model based on data from the Guangzhou Lung Cancer Screening Program, examining 236 different screening strategies varying by age, risk thresholds, and smoking status. The primary measures included quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs).
– Tailoring screening initiation age and risk thresholds for smokers and nonsmokers can maximize health benefits while minimizing costs.
– Annual screening emerges as the most efficient strategy for both demographic groups, outperforming current guidelines.
– The optimal strategies provide significant incremental QALYs at acceptable cost levels, supporting broader implementation.
Results indicate that for smokers, annual screening starting at age 45 with a 0.55% three-year lung cancer risk offers the greatest QALY gains within the willingness-to-pay threshold of $38,224. This approach surpasses the 2023 Chinese guidelines in effectiveness. Similarly, for nonsmokers, initiating annual screenings at age 45 with a 0.20% three-year risk proves most cost-effective.
This economic evaluation demonstrates that the NCC-LCm2021 model-based screening strategies are financially viable for China’s diverse population. By customizing risk thresholds, the model enhances the efficiency of lung cancer screening, ensuring resources are allocated where they are most needed.
Implementing these optimized screening strategies could lead to earlier detection and treatment of lung cancer, ultimately reducing mortality rates and improving quality of life for millions. Health policymakers should consider integrating these findings into national screening programs to achieve better health outcomes and sustainable healthcare spending.
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