Abstract
OBJECTIVES: This study examined the cost-effectiveness of general and targeted strategies for residential radon testing and mitigation in the United States. METHODS: A decision-tree model was used to perform a cost-effectiveness analysis of preventing radon-associated deaths from lung cancer. RESULTS: For a radon threshold of 4 pCi/L, the estimated costs to prevent 1 lung cancer death are about $3 million (154 lung cancer deaths prevented), or $480,000 per life-year saved, based on universal radon screening and mitigation, and about $2 million (104 lung cancer deaths prevented), or $330,000 per life-year saved, if testing and mitigation are confined to geographic areas at high risk for radon exposure. For mitigation undertaken after a single screening test and after a second confirmatory test, the estimated costs are about $920,000 and $520,000, respectively, to prevent a lung cancer death with universal screening and $130,000 and $80,000 per life-year for high risk screening. The numbers of preventable lung cancer deaths are 811 and 527 for universal and targeted approaches, respectively. CONCLUSIONS: These data suggest possible alternatives to current recommendations.
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Selected References
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- Abelson P. H. Uncertainties about health effects of radon. Science. 1990 Oct 19;250(4979):353–353. doi: 10.1126/science.2218536. [DOI] [PubMed] [Google Scholar]
- Bowie C., Bowie S. H. Radon and health. Lancet. 1991 Feb 16;337(8738):409–413. doi: 10.1016/0140-6736(91)91177-v. [DOI] [PubMed] [Google Scholar]
- Cummings S. R., Rubin S. M., Oster G. The cost-effectiveness of counseling smokers to quit. JAMA. 1989 Jan 6;261(1):75–79. [PubMed] [Google Scholar]
- Evdokimoff V., Ozonoff D. Compliance with EPA guidelines for follow-up testing and mitigation after radon screening measurements. Health Phys. 1992 Aug;63(2):215–217. doi: 10.1097/00004032-199208000-00012. [DOI] [PubMed] [Google Scholar]
- Fiscella K., Franks P. Cost-effectiveness of the transdermal nicotine patch as an adjunct to physicians' smoking cessation counseling. JAMA. 1996 Apr 24;275(16):1247–1251. [PubMed] [Google Scholar]
- Ford E. S., Eheman C. R. Radon retesting and mitigation behavior among the U.S. population. Health Phys. 1997 Apr;72(4):611–614. doi: 10.1097/00004032-199704000-00013. [DOI] [PubMed] [Google Scholar]
- Ford E. S., Eheman C. R., Siegel P. Z., Garbe P. L. Radon awareness and testing behavior: findings from the Behavioral Risk Factor Surveillance System, 1989-1992. Health Phys. 1996 Mar;70(3):363–366. doi: 10.1097/00004032-199603000-00006. [DOI] [PubMed] [Google Scholar]
- Hodgson T. A. Cigarette smoking and lifetime medical expenditures. Milbank Q. 1992;70(1):81–125. [PubMed] [Google Scholar]
- Lubin J. H., Steindorf K. Cigarette use and the estimation of lung cancer attributable to radon in the United States. Radiat Res. 1995 Jan;141(1):79–85. [PubMed] [Google Scholar]
- Maillie H. D., Simon W., Greenspan B. S., Watts R. J., Quinn B. R. The influence of life table corrections for smokers and nonsmokers on the health effects of radon using the BEIR (biological effects of ioniziing radiation) IV method. Health Phys. 1994 Jun;66(6):615–620. doi: 10.1097/00004032-199406000-00001. [DOI] [PubMed] [Google Scholar]
- Moeller D. W., Fujimoto K. Cost evaluation of control measures for indoor radon progeny. Health Phys. 1984 Jun;46(6):1181–1193. doi: 10.1097/00004032-198406000-00002. [DOI] [PubMed] [Google Scholar]
- Mossman K. L., Sollitto M. A. Regulatory control of indoor Rn. Health Phys. 1991 Feb;60(2):169–176. doi: 10.1097/00004032-199102000-00004. [DOI] [PubMed] [Google Scholar]
- Oster G., Huse D. M., Delea T. E., Colditz G. A. Cost-effectiveness of nicotine gum as an adjunct to physician's advice against cigarette smoking. JAMA. 1986 Sep 12;256(10):1315–1318. [PubMed] [Google Scholar]
- Puskin J. S., Nelson C. B. EPA's perspective on risks from residential radon exposure. JAPCA. 1989 Jul;39(7):915–920. doi: 10.1080/08940630.1989.10466577. [DOI] [PubMed] [Google Scholar]
- Rice D. P., Hodgson T. A., Sinsheimer P., Browner W., Kopstein A. N. The economic costs of the health effects of smoking, 1984. Milbank Q. 1986;64(4):489–547. [PubMed] [Google Scholar]
- Samet J. M., Hornung R. W. Review of radon and lung cancer risk. Risk Anal. 1990 Mar;10(1):65–75. doi: 10.1111/j.1539-6924.1990.tb01021.x. [DOI] [PubMed] [Google Scholar]
- Warner K. E., Mendez D., Courant P. N. Toward a more realistic appraisal of the lung cancer risk from radon: the effects of residential mobility. Am J Public Health. 1996 Sep;86(9):1222–1227. doi: 10.2105/ajph.86.9.1222. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wozniak S. J. Lung cancer and radon. BMJ. 1992 Jun 13;304(6841):1571–1571. doi: 10.1136/bmj.304.6841.1571-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
