Rosell Antoni, Baeza Sonia, Mouriño Rocío, Saigí Maria, Munné Marta, López de Castro Pedro, Bechini Jordi, Estrada Oriol, Ara Jordi, Ricou Laura, López-Seguí Francesc
Barcelona Respiratory Network (BRN), Thorax Institute, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona (UAB), Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain.
Germans Trias i Pujol University Hospital, Department of Medicine, Autonomous University of Barcelona (UAB), Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain.
BMC Health Serv Res. 2025 Jul 30;25(1):1001. doi: 10.1186/s12913-025-13008-w.
NLST and NELSON trial showed that lung cancer mortality can be reduced by 20-24% using low-dose computed tomography screening, due to an increase in early-stage diagnoses.
How much lung cancer-related direct costs may be reduced using low-dose computed tomography screening based on the ILST-protocol in a public healthcare system?
Cost analysis of lung cancer screening vs. usual care in the framework of the retail price of the Catalan public healthcare system. The lung cancer screening group included costs of screening (ILST-protocol), treatment cost according to weighted average distribution of TNM staging in the NLST and NELSON trials, lung cancer detection rate and smoking-cessation intervention. The usual care group included treatment costs based on distribution of TNM staging registered in the Spanish index hospital.
In the usual care group, treatment costs were €91,959. In 5-year of lung cancer screening program, the average expected costs per subject were €1,342 (range €1,054 - 1,832) for screening and €32,431 for treatment, with an expected reduction of €952 based on an average cancer detection rate of 1.6%. The decrease in cost resulting from the stage shift offsets 70.6% of the costs of the screening program.
The decrease in direct costs associated with lung cancer treatment due to a stage shift resulting from LCS of high-risk populations compensates for a substantial part of the LCS program costs.
Retrospectively registered.
国家肺癌筛查试验（NLST）和荷兰-比利时肺癌筛查随机对照试验（NELSON）表明，由于早期诊断的增加，使用低剂量计算机断层扫描筛查可使肺癌死亡率降低20%-24%。
在公共医疗系统中，基于国际肺癌筛查试验（ILST）方案的低剂量计算机断层扫描筛查可降低多少与肺癌相关的直接成本？
在加泰罗尼亚公共医疗系统零售价框架内，对肺癌筛查与常规护理进行成本分析。肺癌筛查组包括筛查成本（ILST方案）、根据NLST和NELSON试验中TNM分期的加权平均分布计算的治疗成本、肺癌检出率和戒烟干预。常规护理组包括基于西班牙索引医院登记的TNM分期分布的治疗成本。
在常规护理组中，治疗成本为91,959欧元。在为期5年的肺癌筛查项目中，每位受试者的平均预期成本为筛查1,342欧元（范围为1,054-1,832欧元），治疗32,431欧元，基于1.6%的平均癌症检出率，预期降低952欧元。分期转移导致的成本降低抵消了筛查项目成本的70.6%。
高危人群低剂量计算机断层扫描筛查导致的分期转移使肺癌治疗相关直接成本降低，这抵消了低剂量计算机断层扫描筛查项目成本的很大一部分。
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