Table 4. Cost-effectiveness estimates for lung cancer screening scenarios on the efficient frontier.
| Scenario # | Starting age of screening | Stopping age of screening | Screening interval | Maximum number of years since cessation | Cumulative smoking criteria | Exclusion from further screening invitations after reaching the maximum number of years since cessation | Discounted costs compared to no screening (in Canadian dollars) per 100,000 | Discounted life-years gained per 100,000 | Costs (in Canadian dollars) per life-year gained (discounted)/ACER compared to no screening | ICER compared to the previous efficient scenario |
|---|---|---|---|---|---|---|---|---|---|---|
| #1 | 60 | 75 | Annual | 10 | 40 pack-years (NLST-like) | Yes | $49,768,886 | 1,276 | $39,006 | - |
| #2 | 55 | 75 | Annual | 10 | 40 pack-years (NLST-like) | Yes | $58,549,938 | 1,489 | $39,311 | $41,136 |
| #3 | 55 | 75 | Annual | 10 | 30 pack-years (NLST-like) | Yes | $72,978,421 | 1,746 | $41,801 | $56,262 |
| #4 | 55 | 80 | Annual | 10 | 30 pack-years (NLST-like) | Yes | $78,858,485 | 1,834 | $43,001 | $66,802 |
| #5 | 55 | 75 | Annual | 15 | 30 pack-years (NLST-like) | Yes | $87,658,495 | 1,965 | $44,600 | $66,885 |
| #6 | 55 | 80 | Annual | 15 | 30 pack-years (NLST-like) | Yes | $95,859,980 | 2,088 | $45,916 | $67,065 |
| #7 | 55 | 80 | Annual | 20 | 30 y of smoking at least 15 cigarettes per day or 35 y of smoking at least 10 cigarettes per day (NELSON-like) | Yes | $114,462,449 | 2,359 | $48,530 | $68,675 |
| #8 | 55 | 80 | Annual | 20 | 30 y of smoking at least 15 cigarettes per day or 35 y of smoking at least 10 cigarettes per day (NELSON-like) | No | $124,978,314 | 2,500 | $49,998 | $74,557 |
| #9 | 50 | 80 | Annual | 20 | 30 y of smoking at least 15 cigarettes per day or 35 y of smoking at least 10 cigarettes per day (NELSON-like) | No | $131,929,978 | 2,592 | $50,901 | $75,370 |
| #10 | 50 | 80 | Annual | 20 | 25 y of smoking at least 15 cigarettes per day or 30 y of smoking at least 10 cigarettes per day (NELSON-like) | No | $162,994,771 | 2,877 | $56,661 | $109,083 |
| #11 | 50 | 80 | Annual | 20 | 25 y of smoking at least 10 cigarettes per day or 30 y of smoking at least 5 cigarettes per day (NELSON-like) | No | $206,703,139 | 3,214 | $64,304 | $129,394 |
Results are per 100,000 individuals alive at the start of 2015. An annual discount rate of 3% annually was applied to costs and life-years gained.