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Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy

BACKGROUND: After implementation of the PREDICA annual chest X-ray (CXR) screening program in smokers in the general practice setting of Varese-Italy a significant reduction in lung cancer-specific mortality (18 %) was observed. The objective of this study covering July 1997 through December 2006 wa...

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Autores principales: Pertile, Paolo, Poli, Albino, Dominioni, Lorenzo, Rotolo, Nicola, Nardecchia, Elisa, Castiglioni, Massimo, Paolucci, Massimo, Mantovani, William, Imperatori, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4567810/
https://www.ncbi.nlm.nih.gov/pubmed/26366122
http://dx.doi.org/10.1186/s12962-015-0041-0
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author Pertile, Paolo
Poli, Albino
Dominioni, Lorenzo
Rotolo, Nicola
Nardecchia, Elisa
Castiglioni, Massimo
Paolucci, Massimo
Mantovani, William
Imperatori, Andrea
author_facet Pertile, Paolo
Poli, Albino
Dominioni, Lorenzo
Rotolo, Nicola
Nardecchia, Elisa
Castiglioni, Massimo
Paolucci, Massimo
Mantovani, William
Imperatori, Andrea
author_sort Pertile, Paolo
collection PubMed
description BACKGROUND: After implementation of the PREDICA annual chest X-ray (CXR) screening program in smokers in the general practice setting of Varese-Italy a significant reduction in lung cancer-specific mortality (18 %) was observed. The objective of this study covering July 1997 through December 2006 was to estimate the cost-effectiveness of this intervention. METHODS: We examined detailed information on lung cancer (LC) cases that occurred among smokers invited to be screened in the PREDICA study (Invitation-to-screening Group, n = 5815 subjects) to estimate costs and quality-adjusted life-years (QALYs) from LC diagnosis until death. The control group consisted of 156 screening-eligible smokers from the same area, uninvited and unscreened, who developed LC and were treated by usual care. We calculated the incremental net monetary benefit (INMB) by comparing LC management in screening participants (n = 1244 subjects) and in the Invitation-to-screening group versus control group. RESULTS: The average number of QALYs since LC diagnosis was 1.7, 1.49 and 1.07, respectively, in screening participants, the invitation-to-screening group, and the control group. The average total cost (screening + management) per LC case was higher in screening participants (€17,516) and the Invitation-to-screening Group (€16,167) than in the control group (€15,503). Assuming a maximum willingness to pay of €30,000/QALY, we found that the intervention was cost-effective with high probability: 79 % for screening participation (screening participants vs. control group) and 95 % for invitation-to-screening (invitation-to-screening group vs. control group). CONCLUSIONS: Based on the PREDICA study, annual CXR screening of high-risk smokers in a general practice setting has high probability of being cost-effective with a maximum willingness to pay of €30,000/QALY.
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spelling pubmed-45678102015-09-13 Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy Pertile, Paolo Poli, Albino Dominioni, Lorenzo Rotolo, Nicola Nardecchia, Elisa Castiglioni, Massimo Paolucci, Massimo Mantovani, William Imperatori, Andrea Cost Eff Resour Alloc Research BACKGROUND: After implementation of the PREDICA annual chest X-ray (CXR) screening program in smokers in the general practice setting of Varese-Italy a significant reduction in lung cancer-specific mortality (18 %) was observed. The objective of this study covering July 1997 through December 2006 was to estimate the cost-effectiveness of this intervention. METHODS: We examined detailed information on lung cancer (LC) cases that occurred among smokers invited to be screened in the PREDICA study (Invitation-to-screening Group, n = 5815 subjects) to estimate costs and quality-adjusted life-years (QALYs) from LC diagnosis until death. The control group consisted of 156 screening-eligible smokers from the same area, uninvited and unscreened, who developed LC and were treated by usual care. We calculated the incremental net monetary benefit (INMB) by comparing LC management in screening participants (n = 1244 subjects) and in the Invitation-to-screening group versus control group. RESULTS: The average number of QALYs since LC diagnosis was 1.7, 1.49 and 1.07, respectively, in screening participants, the invitation-to-screening group, and the control group. The average total cost (screening + management) per LC case was higher in screening participants (€17,516) and the Invitation-to-screening Group (€16,167) than in the control group (€15,503). Assuming a maximum willingness to pay of €30,000/QALY, we found that the intervention was cost-effective with high probability: 79 % for screening participation (screening participants vs. control group) and 95 % for invitation-to-screening (invitation-to-screening group vs. control group). CONCLUSIONS: Based on the PREDICA study, annual CXR screening of high-risk smokers in a general practice setting has high probability of being cost-effective with a maximum willingness to pay of €30,000/QALY. BioMed Central 2015-09-12 /pmc/articles/PMC4567810/ /pubmed/26366122 http://dx.doi.org/10.1186/s12962-015-0041-0 Text en © Pertile et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Pertile, Paolo
Poli, Albino
Dominioni, Lorenzo
Rotolo, Nicola
Nardecchia, Elisa
Castiglioni, Massimo
Paolucci, Massimo
Mantovani, William
Imperatori, Andrea
Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy
title Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy
title_full Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy
title_fullStr Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy
title_full_unstemmed Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy
title_short Is chest X-ray screening for lung cancer in smokers cost-effective? Evidence from a population-based study in Italy
title_sort is chest x-ray screening for lung cancer in smokers cost-effective? evidence from a population-based study in italy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4567810/
https://www.ncbi.nlm.nih.gov/pubmed/26366122
http://dx.doi.org/10.1186/s12962-015-0041-0
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