使用诊断性血液检测进行肺癌筛查的卫生经济学评价：苏格兰肺癌早期检测（ECLS）。
Health Economic Evaluation of Lung Cancer Screening Using a Diagnostic Blood Test: The Early Detection of Cancer of the Lung Scotland (ECLS).
机构信息
Department of Applied Economics (Statistics and Econometrics), University of Malaga, El Ejido nº 6, 29013 Malaga, Spain.
Health Economics and Health Technology Assessment (HEHTA), School of Health and Wellbeing, University of Glasgow, Glasgow G12 8TP, UK.
出版信息
Curr Oncol. 2024 Jun 18;31(6):3546-3562. doi: 10.3390/curroncol31060261.
BACKGROUND
Diagnostic blood tests have the potential to identify lung cancer in people at high risk. We assessed the cost-effectiveness of a lung cancer screening intervention, using the EarlyCDT-Lung Test (ECLS) with subsequent X-ray and low-dose chest CT scans (LDCT) for patients with a positive test result, compared to both usual care and LDCT screening for the target population.
METHODS
We conducted a model-based lifetime analysis from a UK NHS and personal social services perspective. We estimated incremental net monetary benefit (NMB) for the ECLS intervention compared to no screening and to LDCT screening.
RESULTS
The incremental NMB of ECLS intervention compared to no screening was GBP 33,179 (95% CI: -GBP 81,396, GBP 147,180) and GBP 140,609 (95% CI: -GBP 36,255, GBP 316,612), respectively, for a cost-effectiveness threshold of GBP 20,000 and GBP 30,000 per quality-adjusted life year. The same figures compared with LDCT screening were GBP 162,095 (95% CI: GBP 52,698, GBP 271,735) and GBP 52,185 (95% CI: -GBP 115,152, GBP 219,711).
CONCLUSIONS
The ECLS intervention is the most cost-effective screening alternative, with the highest probability of being cost-effective, when compared to no screening or LDCT screening. This result may change with modifications of the parameters, suggesting that the three alternatives considered in the main analysis are potentially cost-effective.
背景
诊断性血液检测有可能识别出高危人群中的肺癌。我们评估了一种肺癌筛查干预措施的成本效益，该措施使用早期肺癌检测测试（ECLS），对检测结果阳性的患者进行后续 X 光和低剂量胸部 CT 扫描（LDCT），与目标人群的常规护理和 LDCT 筛查进行比较。
方法
我们从英国国民保健制度和个人社会服务的角度进行了基于模型的终身分析。我们估计了 ECLS 干预措施与不筛查和 LDCT 筛查相比的增量净货币收益（NMB）。
结果
与不筛查相比，ECLS 干预措施的增量 NMB 分别为 GBP33179（95%CI：-GBP81396，GBP147180）和 GBP140609（95%CI：-GBP36255，GBP316612），对于 GBP20000 和 GBP30000 每质量调整生命年的成本效益阈值。与 LDCT 筛查相比，同样的数字分别为 GBP162095（95%CI：GBP52698，GBP271735）和 GBP52185（95%CI：-GBP115152，GBP219711）。
结论
与不筛查或 LDCT 筛查相比，ECLS 干预措施是最具成本效益的筛查替代方案，具有最高的成本效益可能性。这一结果可能会随着参数的修改而改变，这表明在主要分析中考虑的三种替代方案具有潜在的成本效益。
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