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Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects

Author

Listed:
  • Sébastien Gendarme

    (CHIC - Centre Hospitalier Intercommunal de Créteil, IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CEpiA - Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12)

  • Jean-Claude Pairon

    (IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France)

  • Pascal Andujar

    (IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France)

  • François Laurent

    (CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] - Université Bordeaux Segalen - Bordeaux 2 - CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Patrick Brochard

    (CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux, EPICENE - Cancer environnement - BPH - Bordeaux population health - UB - Université de Bordeaux - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Fleur Delva

    (EPICENE - Cancer environnement - BPH - Bordeaux population health - UB - Université de Bordeaux - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Bénédicte Clin

    (CHU Caen - NU - Normandie Université - TCBN - Tumorothèque de Caen Basse-Normandie, UNICAEN - Université de Caen Normandie - NU - Normandie Université)

  • Antoine Gislard

    (ABTE - Aliments Bioprocédés Toxicologie Environnements - UNICAEN - Université de Caen Normandie - NU - Normandie Université - UNIROUEN - Université de Rouen Normandie - NU - Normandie Université, CHU Rouen - NU - Normandie Université)

  • Christophe Paris

    (CHIC - Centre Hospitalier Intercommunal de Créteil)

  • Isabelle Thaon

    (CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy)

  • Helene Goussault

    (IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France)

  • Florence Canoui-Poitrine

    (IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil] - IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12)

  • Christos Chouaïd

    (CHIC - Centre Hospitalier Intercommunal de Créteil, U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil] - IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12)

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Suggested Citation

  • Sébastien Gendarme & Jean-Claude Pairon & Pascal Andujar & François Laurent & Patrick Brochard & Fleur Delva & Bénédicte Clin & Antoine Gislard & Christophe Paris & Isabelle Thaon & Helene Goussault &, 2022. "Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects," Post-Print hal-03783819, HAL.
    • Handle: RePEc:hal:journl:hal-03783819
    DOI: 10.3390/cancers14174089
    Note: View the original document on HAL open archive server: https://hal.science/hal-03783819v1
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    References listed on IDEAS

    as
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    2. Claire Williams & James D. Lewsey & Daniel F. Mackay & Andrew H. Briggs, 2017. "Estimation of Survival Probabilities for Use in Cost-effectiveness Analyses: A Comparison of a Multi-state Modeling Survival Analysis Approach with Partitioned Survival and Markov Decision-Analytic Mo," Medical Decision Making, , vol. 37(4), pages 427-439, May.
    3. Adam J. N. Raymakers & John Mayo & Stephen Lam & J. Mark FitzGerald & David G. T. Whitehurst & Larry D. Lynd, 2016. "Cost-Effectiveness Analyses of Lung Cancer Screening Strategies Using Low-Dose Computed Tomography: a Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 14(4), pages 409-418, August.
    4. Andrea C Villanti & Yiding Jiang & David B Abrams & Bruce S Pyenson, 2013. "A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-11, August.
    5. Steven B. Markowitz, 2022. "Lung Cancer Screening in Asbestos-Exposed Populations," IJERPH, MDPI, vol. 19(5), pages 1-15, February.
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    Keywords

    lung neoplasms; screening; occupational diseases; asbestos; cost-effectiveness;
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