Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects.
Fiche publication
Date publication
août 2022
Journal
Cancers
Auteurs
Membres identifiés du Cancéropôle Est :
Dr THAON Isabelle
Tous les auteurs :
Gendarme S, Pairon JC, Andujar P, Laurent F, Brochard P, Delva F, Clin B, Gislard A, Paris C, Thaon I, Goussault H, Canoui-Poitrine F, Chouaïd C
Lien Pubmed
Résumé
: The National Lung Screening Trial (NLST) and NELSON study opened the debate on the relevance of lung cancer (LC) screening in subjects exposed to occupational respiratory carcinogens. This analysis reported the incremental cost-effectiveness ratios (ICER) of an organized LC screening program for an asbestos-exposed population. Using Markov modelization, individuals with asbestos exposure were either monitored without intervention or annual low-dose thoracic computed-tomography (LDTCT) scan LC screening. LC incidence came from a prospective observational cohort of subjects with occupational asbestos exposure. The intervention parameters were those of the NLST study. Utilities and LC-management costs came from published reports. A sensitivity analysis evaluated different screening strategies. The respective quality-adjusted life year (QALY) gain, supplementary costs and ICER [95% confidence interval] were: 0.040 [0.010-0.065] QALY, 6900 [3700-11,800] € and 170,000 [75,000-645,000] €/QALY for all asbestos-exposed subjects; and 0.144 [0.071-0.216] QALY, 13,000 [5700-26,800] € and 90,000 [35,000-276,000] €/QALY for smokers with high exposure. When screening was based on biennial LDTCT scans, the ICER was 45,000 [95% CI: 15,000-116,000] €/QALY. Compared to the usual ICER thresholds, biennial LDTCT scan LC screening for smokers with high occupational exposure to asbestos is acceptable and preferable to annual scans.
Mots clés
asbestos, cost-effectiveness, lung neoplasms, occupational diseases, screening
Référence
Cancers (Basel). 2022 08 24;14(17):