CONTENTS:

1.12 Reduction in Lung Cancer Mortality Rate Due to Screening.
1.13 Is Screening for Lung Cancer Cost-Effective?

Forward to 1K Future Developments in Lung Cancer Detection..   Back to 1I Guidelines for Lung Cancer Screening.

Did you hear about the flasher who was thinking about retiring? He finally decided to stick it out for one more year.

1.12 Reduction in the Lung Cancer Mortality Rate Due to Screening

 
The National Lung Screening Trial  (NLST), a randomized clinical trial demonstrated a lung cancer mortality benefit of 20 %, with mortality due to all causes being reduced by 6.7 % in screened patients.

For the NLST participants, analysis over a 6-year period, showed that screening could prevent 3.9 deaths per 1000 persons. This data equates to the screening of 256 individuals annually for three years, just to prevent one lung cancer death over six years.

That’s 256 CT scans yearly for three years to prevent one lung cancer death.

The key to dramatically decreasing lung cancer rates lies with smoking education and information, especially prevention in young people.

A ‘risk model‘ derived from the 2010 NLST data has shown that up to 8.6 million people in the US would have met the NLST screening criteria. Apparently 12,000 lung cancer deaths in the US could be prevented per year with full implementation of screening. This NSLT data analysis provides the best lung cancer screening modeling data at the present time.

‘Kiss my Butt!’ What? It’s the name of my new anti-smoking campaign.

1.13 Is Screening for Lung Cancer Cost-Effective?

 
Cost-effectiveness of any screening program is a major issue. Not only are costs involved in the initial screening rounds but also the follow-up of the false-positive tests identified with LDCT screening. There may also be high procedural complication rates, for second-line tests. So far the NLST has provided the most useful data on costs.

In 2011, an analysis by McMahon and colleagues of lung cancer screening costs showed that LDCT screening could decrease lung cancer mortality at ten years by between 18 % to 25 %, with costs ranging from $126,000 to $269,000 per ‘quality adjusted life year‘ (QALY).

What’s a ‘Quality Adjusted Life Year’?

Quality Adjusted Life Year is the arithmetic product of life expectancy and a measure of the quality of the remaining life-years.  

In comparison, the cost-effectiveness ratio for colorectal cancer screening is $47,700 and for breast cancer screening is $13,000 to $32,000 per QALY, respectively.  The LDCT model also showed that a program of smoking cessation was more cost-effective than lung cancer screening with LDCT alone or LDCT combined with smoking cessation.

Don’t forget, it was only recently discovered that research causes cancer…in rats!

References:

National Lung Screening Trial Research Team. (2011) The National Lung Screening Trial: Overview and Study Design. Radiology. 2011 Jan; 258(1): 243–253. (Retrieved 7^th April 2015): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3009383/

Aberle DR, Adams AM, berg CD, Black WC, Clapp JD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011;365:395–409. (Retrieved 23^rd Jan 2015): http://www.ncbi.nlm.nih.gov/pubmed/21714641

More references for this section are on this page.

Patient Information:

National Lung Screening Trial (NLST). Study Facts from the NCI. (Retrieved 22^nd Jan 2015): http://www.cancer.gov/clinicaltrials/noteworthy-trials/nlst

World Health Organization (WHO) Cancer prevention. (Retrieved 5^th April 2015): http://www.who.int/cancer/prevention/en/

More patient information for this section is on this page..

Forward to 1K Future Developments in Lung Cancer Detection..   Back to 1I Guidelines for Lung Cancer Screening.