[Comparison of two types of mass screening for lung cancer in terms of cost-effectiveness: indirect chest X-ray vs LSCT].

Mass screening for lung cancer is widely performed in Japan, with the photofluoroscopic examination and sputum cytology used as the screening methods. However the clinical efficacy of these screening methods is considered to be inadequate in terms of the survival rate of the screened population. In the previous report we proposed that a specially designed CT technique, called lung cancer screening CT (LSCT), may be useful in screening for lung cancer. In this paper a preliminary comparison is made between the present and future methods of lung cancer screening in terms of cost-effectiveness. A model for cost-effectiveness analysis estimates the net life-years saved by screening and then determines the direct cost of screening including cost of therapy. Various factors are taken into account such as sensitivity of the screening methods, rate of participation in detailed examination, 5-year survival rate of the screened population, cost of the screening method, and average cost of therapy for screen-detected patients and outpatients. An example of the results is as follows: for a population with a lung cancer incidence of 200 x 10(-5) person/year and life expectancy of 30 years, the net person years saved are 672 x 10(-5) for the present screening method and 2376 x 10(-5) for LSCT screening. The cost required to save one person year are 1.46 x 10(5) yen for the present screening method and 2.03 x 10(5) yen for LSCT screening.(ABSTRACT TRUNCATED AT 250 WORDS)