Table 1.
Annual CT screening (≥20 pack-year smoking history) vs. no intervention.
| Cohort sex | Cohort age | Screen frequency/ages | % of cohort screened | Risk of radiation-induced lung cancer? | Fewer follow-up CT exams? | Incremental cost-effectiveness ratio ($/QALY) | Mortality reduction (%) versus no intervention, (10 year follow-up) | Mortality reduction (%) versus no intervention, (15 year follow-up) |
|---|---|---|---|---|---|---|---|---|
| Males | 50 | annual/50–70 | 69 | − | − | 149,000 | 25.16 | 28.69 |
| + | − | 158,000 | 25.06 | 28.08 | ||||
| − | + | 147,000 | 23.15 | 24.80 | ||||
| + | + | 150,000 | 23.14 | 24.69 | ||||
|
| ||||||||
| 60 | annual/60–74 | 72 | − | − | 135,000 | 25.06 | 27.66 | |
| + | − | 139,000 | 24.96 | 27.18 | ||||
| − | + | 129,000 | 23.01 | 23.80 | ||||
| + | + | 130,000 | 22.99 | 23.71 | ||||
|
| ||||||||
| 70 | annual/70–74 | 70 | − | − | 169,000 | 20.94 | 16.21 | |
| + | − | 172,000 | 20.85 | 15.92 | ||||
| − | + | 160,000 | 19.45 | 14.81 | ||||
| + | + | 160,000 | 19.43 | 14.77 | ||||
|
| ||||||||
| Females | 50 | annual/50–70 | 40 | − | − | 137,000 | 19.48 | 22.37 |
| + | − | 203,000 | 19.18 | 19.63 | ||||
| − | + | 135,000 | 18.09 | 19.44 | ||||
| + | + | 152,000 | 18.03 | 19.00 | ||||
|
| ||||||||
| 60 | annual/60–74 | 47 | − | − | 126,000 | 23.07 | 25.21 | |
| + | − | 151,000 | 22.80 | 22.87 | ||||
| − | + | 121,000 | 21.15 | 21.60 | ||||
| + | + | 127,000 | 21.08 | 21.16 | ||||
|
| ||||||||
| 70 | annual/70–74 | 39 | − | − | 159,000 | 17.98 | 13.26 | |
| + | − | 172,000 | 17.76 | 12.00 | ||||
| − | + | 153,000 | 16.10 | 11.61 | ||||
| + | + | 156,000 | 16.11 | 11.35 | ||||
Scenarios that included (+) risks of radiation induced lung cancer assumed 3.8–3.9mGy (screening CT) and 58mGy (follow-up CT) organ doses, and a 10-year lag between exposure and incidence. See text for details of scenarios that modeled (+) less-intensive follow-up. Costs and QALYs discounted at 3% annually.