Table 1. Input parameters for lung cancer screening model.
| Parameter | Base case estimate | Sensitivity analyses | Reference |
| Costs | |||
| Lung cancer screening | |||
| Average annual cost of low dose spiral CT screening for lung cancer | $210 | 125%, 150% | [7] |
| Lung cancer treatment in first year of diagnosis | |||
| Average cost, Stage A | $82,087 | n/a | [7] |
| Average cost, Stage B | $132,464 | n/a | [7] |
| Average cost, Stage C | $142,750 | n/a | [7] |
| Smoking cessation treatment | |||
| Average cost per smoking cessation counseling session | $83 | n/a | Thomson Reuters Marketscan 2010 trended to 2012 |
| Average cost of generic nicotine replacement therapy per quit attempt | $228 | n/a | Thomson Reuters Marketscan 2010 trended to 2012 |
| Average cost of generic bupropion per quit attempt | $290 | n/a | Thomson Reuters Marketscan 2010 trended to 2012 |
| Average cost of varenicline (Chantix) per quit attempt | $379 | n/a | Thomson Reuters Marketscan 2010 trended to 2012 |
| Average health care costs incurred per quit | $0 | $12,031, $12,093 | Base case: [33]–[35] Sensitivity estimates for light, intensive cessation programs |
| Survival probabilities | % | ||
| Estimated annual survival | |||
| Male, current smoker | 45.7 | [32] | |
| Male, ex-smoker | 63.0 | +/−5% | [32] |
| Male, never smoker | 68.0 | [32] | |
| Female, current smoker | 64.6 | [32] | |
| Female, ex-smoker | 69.6 | +/−5% | [32] |
| Female, never smoker | 82.8 | [32] | |
| Lung cancer survival | |||
| Male, Stage A | 90.4–96.6 | [6] | |
| Male, Stage B | 71.8–89.9 | [6] | |
| Male, Stage C | 26.3–73.7 | [6] | |
| Female, Stage A | 92.1–97.4 | [6] | |
| Female, Stage B | 72.6–90.9 | [6] | |
| Female, Stage C | 27.4–76.0 | [6] | |
| Screening probabilities | |||
| Baseline LDCT scan | |||
| Negative result (no nodules present or semi-positive) | 79.0 | [30], personal communication with C. Henschke | |
| Positive result (nodule>5 mm) | 21.0 | [30], personal communication with C. Henschke | |
| Follow-up scan in 3 months given positive result | 19.0 | [30], personal communication with C. Henschke | |
| Repeat scan at 1 year given follow-up scan | 99.0 | [30], personal communication with C. Henschke | |
| Biopsy given follow-up scan | 1.0 | [30], personal communication with C. Henschke | |
| Surgery given biopsy after follow-up scan | 90.0 | [30], personal communication with C. Henschke | |
| Biopsy given positive result | 2.0 | [30], personal communication with C. Henschke | |
| Repeat scan at 1 year given biopsy | 76.0 | [30], personal communication with C. Henschke | |
| Surgery given biopsy | 24.0 | [30], personal communication with C. Henschke | |
| Repeat LDCT scan (annual) | |||
| Negative result (no nodules present or semi-positive) | 93.0 | [30], personal communication with C. Henschke | |
| Positive result (nodule>5 mm) | 7.0 | [30], personal communication with C. Henschke | |
| Antibiotics and follow-up scan within 1 month given positive result | 3.0 | [30], personal communication with C. Henschke | |
| Repeat scan at 1 year given antibiotics and follow-up scan | 5.0 | [30], personal communication with C. Henschke | |
| Additional follow-up scan at 3 months given antibiotics and follow-up scan | 95.0 | [30], personal communication with C. Henschke | |
| Biopsy given additional follow-up scan | 5.0 | [30], personal communication with C. Henschke | |
| Surgery given biopsy after antibiotics and follow-up scan | 90.0 | [30], personal communication with C. Henschke | |
| Biopsy given antibiotics and follow-up scan | 1.0 | [30], personal communication with C. Henschke | |
| Surgery given biopsy after antibiotics and follow-up scan | 90.0 | [30], personal communication with C. Henschke | |
| Follow-up scan within 6 months given positive result | 4.0 | [30], personal communication with C. Henschke | |
| Repeat scan at 1 year given follow-up scan | 99.0 | [30], personal communication with C. Henschke | |
| Biopsy given follow-up scan | 1.0 | [30], personal communication with C. Henschke | |
| Surgery given biopsy after follow-up scan | 90.0 | [30], personal communication with C. Henschke | |
| Lung cancer probabilities | % | % | |
| Status quo | |||
| Stage A | 17.4 | [5] | |
| Stage B | 14.6 | [5] | |
| Stage C | 68.0 | [5] | |
| Lung cancer screening | New York ELCAP | NLST | |
| Stage A | 79.3 | 63.0 | [10], [30] |
| Stage B | 16.2 | 16.5 | [10], [30] |
| Stage C | 4.5 | 20.5 | [10], [30] |
| Smoking probabilities, % | % | ||
| Male, aged 18+, current smoker | 21.2 | [28] | |
| Male, aged 18+, ex-smoker | 25.5 | [28] | |
| Female, aged 18+, current smoker | 17.5 | [28] | |
| Female, aged 18+, ex-smoker | 17.3 | [28] | |
| Probability of participation in smoking cessation treatment among current smokers | 19.2 | +/−10% | Calculated from [28] |
| Annual reduction in smoking prevalence with increasing age (Background quit rate) | 2.5 | Calculated from [28] | |
| Effectiveness of smoking cessation intervention at 12 months | Odds ratio | ||
| Light cessation intervention (behavioral treatment only) | 1.5 (midpoint of 1.3–1.7) | [37] | |
| Pharmacological treatment only | 2.55 (midpoint of 1.5–3.6) | [37] | |
| Combined behavioral and pharmacological treatment, over either intervention alone | 1.5 (midpoint of 1.3–1.7) | [37] | |
| Intensive cessation intervention (combined behavioral and pharmacological treatment) | 3.04 | Calculated from [37] | |
| Quality-adjusted life years | Utility weight | ||
| Utility for general population, by age | |||
| Males, aged 50–59 | 0.819 | +/−10% | [33] |
| Males, aged 60–69 | 0.803 | +/−10% | [33] |
| Males, aged 70–79 | 0.770 | +/−10% | [33] |
| Males, aged 80–89 | 0.742 | +/−10% | [33] |
| Females, aged 50–59 | 0.788 | +/−10% | [33] |
| Females, aged 60–69 | 0.784 | +/−10% | [33] |
| Females, aged 70–79 | 0.748 | +/−10% | [33] |
| Females, aged 80–89 | 0.700 | +/−10% | [33] |
| Utility weights for lung cancer patients | |||
| Stage A | 0.823 | +/−10% | [34] |
| Stage B | 0.772 | +/−10% | [34] |
| Stage C | 0.573 | +/−10% | [34] |
| QALYs saved by smoking cessation | |||
| Males, aged 55–64 | 2.25 | [38] | |
| Females, aged 55–64 | 2.01 | [38] |
Unless stated, all costs are presented in 2012 dollars.