Health and economic impact at a population level of both primary and secondary preventive lung cancer interventions: A model-based cost-effectiveness analysis
Author
Diaz, Mireia
Garcia, Montse
Vidal, Carmen
Santiago, Albert
Gnutti, Gerard
Gomez, David
Trapero-Bertran, Marta
Fu, Marcela
Lung Cancer Prevention LUCAPREV Research Group
Publication date
2021ISSN
0169-5002
Abstract
Objectives: Robust economic evaluations are needed to identify efficient strategies for lung cancer prevention that combine brief and intensive smoking cessation intervention programmes with screening using low-dose computed tomography (LDCT) at different ages, frequencies, and coverages. We aimed to assess the cost-effectiveness of smoking cessation approaches combined with lung cancer screening in the European context at a population level from a societal perspective. Materials and Methods: A microsimulation model that describes the natural history of lung cancer and incorporates several prevention strategies was developed. Discounted lifetime QALYs and costs at a rate of 3% were used to calculate incremental cost-effectiveness ratios, defined as additional costs in 2017 Euros per QALY gained. Results: Smoking cessation interventions reduce the incidence of lung cancer by 8%-46% and are consistently more effective and cost-effective when starting at younger ages. Screening reduces lung cancer mortality by 1%-24% and is generally less effective and more costly than smoking cessation interventions. The most cost-effective strategy would be to implement intensive smoking cessation interventions at ages 35, 40 and 45, combined with screening every three years between the ages of 55 and 65. Conclusions: Combining smoking cessation interventions with LDCT screening is a very attractive prevention strategy that substantially diminishes the burden of lung cancer. These combined prevention strategies, especially when providing several intensive interventions for smoking cessation at early ages, are more cost-effective than both approaches separately and allow for a more intensified LDCT without losing efficiency.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
Keywords
Rendibilitat
Deixar de fumar
Intervenció intensiva per deixar de fumar
Càncer de pulmó
Cribratge LDCT
Rentabilidad
Dejar de fumar
Intervención intensiva para dejar de fumar
Cáncer de pulmón
Cribado LDCT
Profitability
Stop smoking
Intensive intervention to stop smoking
Lung cancer
LDCT screening
Pages
9
Publisher
Elsevier
Collection
159;
Is part of
Lung Cancer
Citation
Diaz, Mireia; Garcia, Montse; Vidal, Carmen [et al.]. Health and economic impact at a population level of both primary and secondary preventive lung cancer interventions: A model-based cost-effectiveness analysis. Lung Cancer, 2021, 159, p. 153-161. Disponible en: <https://www.lungcancerjournal.info/article/S0169-5002(21)00460-8/fulltext#relatedArticles>. Fecha de acceso: 2 sep. 2021. DOI: 10.1016/j.lungcan.2021.06.027
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Rights
© 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by-nc-nd/4.0/