Pyenson and his colleagues estimated the number of deaths associated with early and late stages of lung cancer over a 15-year period (to reflect the 15 years between ages 50 and 64).
To estimate the number of life-years saved by lung cancer screening, the group used data collected from lung cancer screening programs to predict at what stage lung cancers would have been detected if screening had been in place and as a result how many fewer lung cancer deaths there would have been.
Although the authors concluded that cost-benefit ratio for lung cancer screening is relatively low, one expert suggested they might be underestimating the total cost.
"I can't imagine how it could be that low," said Pamela McMahon, associate director of the Massachusetts General Hospital Institute for Technology Assessment in Boston.
In a 2011 study, McMahon and her colleagues estimated that annual CT screening for people between 50 and 74 who had smoked at least one pack a day for 20 years would cost between $126,000 and $169,000 for every quality-adjusted life-year.
One important difference with McMahon's analysis is that her group considered all costs associated with screening, such as how much a patient would spend to travel to the clinic once a year for screening. "I would imagine this cost is going to be pretty different," McMahon said.
Nonetheless, McMahon thinks that lung cancer screening will eventually be adopted in the United States. "Whether it will be as inexpensive as $19,000 or as expensive as we estimated remains to be seen," she noted.
In addition, McMahon's study found that the cost effectiveness got a boost when screening had an effect on smoking quit rates. If getti
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