Huang Feifei, Lin Xiujing, Hong Yuezhen, Li Yue, Li Yonglin, Chen Wei-Ti, Chen Weisheng
School of Nursing, Fujian Medical University, Fuzhou, 350122, Fujian, China.
School of Basic Medicine, Fujian Medical University, Fuzhou, 350122, Fujian, China.
BMC Cancer. 2025 Feb 25;25(1):345. doi: 10.1186/s12885-025-13710-2.
Low-dose computed tomography (LDCT) significantly increases early detection rates of lung cancer and reduces lung cancer-related mortality by 20%. However, many significant screening barriers remain. This study conduct an initial feasibility and cost-effectiveness analysis of a community-based program that used a mobile low-dose computed tomography (LDCT) scan unit and discuss the operational challenges faced during its implementation.
This study was conducted in rural areas in Fujian Province, China from July 2022 to August 2022. Individuals aged 40 years and above who had not previously undergone LDCT and who were socioeconomically marginalized were included. Participants received a LDCT program from a multidisciplinary research team. Physicians analyzed the images with the assistance of artificial intelligence "InferRead CT Lung Research" and completed structured reports on their impressions. The primary evaluation indicators for mobile LDCT screening effectiveness were the lung cancer detection rate and diagnosis rate, while the main evaluation indicators for cost-effective analysis were the cost-effective ratio and early detection cost index.
A total of 10,159 individuals participated in this study. The detection rates of suspected lung cancer cases and confirmed cases were 1.06% (n = 108) and 0.7% (n = 71), respectively. The cost of lung cancer screening (LCS) was ¥1,203,504 (US$188,847.71), the average cost per screening was ¥118.47 (US$18.65), and the cost effective ratios for the detection of suspected lung cancer and confirmed lung cancer were ¥11,143.56 (US$1,753.29) and ¥16,950.76 (US$2,669.94), respectively. The early detection cost indices for suspected lung cancer were 0.09 and 0.13 for confirmed lung cancer, respectively.
This LDCT with artificial intelligence model for LCS holds economic promise for reducing health disparities in underserved areas and promote larger populations in similar low-income country.
低剂量计算机断层扫描（LDCT）显著提高了肺癌的早期检测率，并将肺癌相关死亡率降低了20%。然而，许多重大的筛查障碍仍然存在。本研究对一个使用移动低剂量计算机断层扫描（LDCT）扫描单元的社区项目进行了初步的可行性和成本效益分析，并讨论了实施过程中面临的操作挑战。
本研究于2022年7月至2022年8月在中国福建省农村地区进行。纳入年龄在40岁及以上、此前未接受过LDCT且社会经济地位边缘化的个体。参与者接受了一个多学科研究团队提供的LDCT项目。医生在人工智能“InferRead CT Lung Research”的辅助下分析图像，并完成关于其印象的结构化报告。移动LDCT筛查效果的主要评估指标是肺癌检测率和诊断率，而成本效益分析的主要评估指标是成本效益比和早期检测成本指数。
共有10159人参与了本研究。疑似肺癌病例和确诊病例的检测率分别为1.06%（n = 108）和0.7%（n = 71）。肺癌筛查（LCS）成本为1203504元（188847.71美元），每次筛查的平均成本为118.47元（18.65美元），检测疑似肺癌和确诊肺癌的成本效益比分别为11143.56元（1753.29美元）和16950.76元（2669.94美元）。疑似肺癌的早期检测成本指数分别为0.09，确诊肺癌的为0.13。
这种用于肺癌筛查的带有人工智能模型的LDCT在减少服务不足地区的健康差距以及促进类似低收入国家更多人群的筛查方面具有经济前景。
