%0 Journal Article
%@ 2369-2960
%I JMIR Publications
%V 8
%N 7
%P e36425
%T Cost-Effectiveness of Lung Cancer Screening Using Low-Dose Computed Tomography Based on Start Age and Interval in China: Modeling Study
%A Zhao,Zixuan
%A Du,Lingbin
%A Li,Yuanyuan
%A Wang,Le
%A Wang,Youqing
%A Yang,Yi
%A Dong,Hengjin
%+ Department of Science and Education of the Fourth Affiliated Hospital, Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, No. 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China, 86 13221076129, donghj@zju.edu.cn
%K cost-effectiveness analysis
%K low-dose computed tomography
%K screening
%K lung cancer
%K China
%D 2022
%7 6.7.2022
%9 Original Paper
%J JMIR Public Health Surveill
%G English
%X Background: Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer-related death in China. The effectiveness of screening for lung cancer has been reported to reduce lung cancer–specific and overall mortality, although the cost-effectiveness, optimal start age, and screening interval remain unclear. Objective: This study aimed to assess the cost-effectiveness of lung cancer screening among heavy smokers in China by incorporating start age and screening interval. Methods: A Markov state-transition model was used to assess the cost-effectiveness of a lung cancer screening program in China. The evaluated screening strategies were based on a screening start age of 50-74 years and a screening interval of once or annually. Transition probabilities were obtained from the literature and validated, while cost parameters were derived from databases of local medical insurance bureaus. A societal perspective was adopted. The outputs of the model included costs, quality-adjusted life years (QALYs), and lung cancer–specific mortality, with future costs and outcomes discounted by 5%. A currency exchange rate of 1 CNY=0.1557 USD is applicable. The incremental cost-effectiveness ratio (ICER) was calculated for different screening strategies relative to nonscreening. Results: The proposed model suggested that screening led to a gain of 0.001-0.042 QALYs per person as compared with the findings in the nonscreening cohort. Meanwhile, one-time and annual screenings were associated with reductions in lung cancer–related mortality of 0.004%-1.171% and 6.189%-15.819%, respectively. The ICER ranged from 119,974.08 to 614,167.75 CNY per QALY gained relative to nonscreening. Using the World Health Organization threshold of 212,676 CNY per QALY gained, annual screening from a start age of 55 years and one-time screening from the age of 65 years can be considered as cost-effective in China. Deterministic and probabilistic sensitivity analyses were conducted. Conclusions: This economic evaluation revealed that a population-based lung cancer screening program in China for heavy smokers using low-dose computed tomography was cost-effective for annual screening of smokers aged 55-74 years and one-time screening of those aged 65-74 years. Moreover, annual lung cancer screening should be promoted in China to realize the benefits of a guideline-recommended screening program. 
%M 35793127
%R 10.2196/36425
%U https://publichealth.jmir.org/2022/7/e36425
%U https://doi.org/10.2196/36425
%U http://www.ncbi.nlm.nih.gov/pubmed/35793127