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Background <p>Low-dose computed tomography (CT) screening for lung cancer is available for high-risk individuals in England. Screening simultaneously for upper abdominal conditions, including cancer, is feasible. Here, we estimate the cost-effectiveness of one-off upper abdominal CT screening, added onto lung cancer screening, based on the Yorkshire Kidney Screening Trial (YKST) feasibility study.</p> Methods <p>A multi-disease health economic model was developed. Ten cancers and abdominal aortic aneurysm (AAA) were modelled over a lifetime horizon. YKST data informed disease prevalence, resource use and screening costs. Costs, quality-adjusted life-years (QALYs) and cost-effectiveness were estimated probabilistically.</p> Results <p>Screening per person costs £70.89, produces 0.0059 QALYs, and has 96% probability of being cost-effective, with an incremental cost-effectiveness ratio of £12,085. AAA contributes most to cost-effectiveness, followed by kidney cancer, but some cancer findings reduce cost-effectiveness. Screening is more cost-effective at younger ages. Screen-detectable disease prevalence, severity and mortality risk contribute most to uncertainty.</p> Conclusions <p>One-off upper abdominal CT screening is potentially cost-effective, but costs, harms and benefits vary between conditions. Cost-effectiveness is driven by early diagnosis of AAA, then kidney cancer, illustrating the importance of considering all relevant diseases in screening models. A larger trial would provide more robust data to refine the cost-effectiveness argument.</p> Clinical Trial Registration <p>ClinicalTrials.gov: NCT05005195</p>

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Cost-effectiveness of one-off upper abdominal CT screening as an add-on to lung cancer screening in England

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月14日

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  • Chloe Thomas,
  • Laura Heathcote,
  • Yuxiao Sun,
  • Matthew E. J. Callister,
  • Jessica Kitt,
  • Sabrina H. Rossi,
  • Bethany Shinkins,
  • Juliet A. Usher-Smith,
  • Sophie Whyte,
  • Grant D. Stewart,
  • Angela Godoy,
  • Sarah W. Burge,
  • Fiona Farquhar,
  • Suzanne Rogerson,
  • Jon Cartledge,
  • Michael Kimuli,
  • Simon Burbidge,
  • Iztok Caglic,
  • Emma Collins,
  • Philip A. J. Crosbie,
  • Gareth R. Iball,
  • Golnessa Masson,
  • Matthew Ward,
  • Claire Eckert,
  • Sheila Fraser,
  • Neil Hancock,
  • Catriona Marshall,
  • Richard D. Neal,
  • Andrew Smith,
  • Irene Simmonds,
  • Tom Wallace

摘要

Background

Low-dose computed tomography (CT) screening for lung cancer is available for high-risk individuals in England. Screening simultaneously for upper abdominal conditions, including cancer, is feasible. Here, we estimate the cost-effectiveness of one-off upper abdominal CT screening, added onto lung cancer screening, based on the Yorkshire Kidney Screening Trial (YKST) feasibility study.

Methods

A multi-disease health economic model was developed. Ten cancers and abdominal aortic aneurysm (AAA) were modelled over a lifetime horizon. YKST data informed disease prevalence, resource use and screening costs. Costs, quality-adjusted life-years (QALYs) and cost-effectiveness were estimated probabilistically.

Results

Screening per person costs £70.89, produces 0.0059 QALYs, and has 96% probability of being cost-effective, with an incremental cost-effectiveness ratio of £12,085. AAA contributes most to cost-effectiveness, followed by kidney cancer, but some cancer findings reduce cost-effectiveness. Screening is more cost-effective at younger ages. Screen-detectable disease prevalence, severity and mortality risk contribute most to uncertainty.

Conclusions

One-off upper abdominal CT screening is potentially cost-effective, but costs, harms and benefits vary between conditions. Cost-effectiveness is driven by early diagnosis of AAA, then kidney cancer, illustrating the importance of considering all relevant diseases in screening models. A larger trial would provide more robust data to refine the cost-effectiveness argument.

Clinical Trial Registration

ClinicalTrials.gov: NCT05005195