Kevin ten Haaf

MSc

Erasmus MC

Scientific researcher

NLST (Learn more about this study)

NLST-87

Aug 20, 2014

Investigating the (cost-)effectiveness of implementing lung cancer screening policies in the province of Ontario, Canada, using microsimulation modeling.

The Cancer Intervention and Surveillance Modeling Network (CISNET) Lung group recently investigated the benefits and harms of implementing lung cancer screening in the U.S. These analyses were used to inform the United States Preventive Services Task Force (USPSTF) on lung cancer screening, which decided to recommend annual screening to smokers aged 55 through 80, who smoked at least 30 pack-years and quit less than 15 years ago (1-3).

However, while the CISNET-Lung group investigated the benefits and harms of lung cancer screening, they did not examine its cost-effectiveness. While some investigators have looked into the cost-effectiveness of lung cancer screening, their analyses did not take the results of the National Lung Screening Trial (NLST) into account (4). Moreover, previous analyses focused solely on the population of the United States and did not investigate the effects of implementing lung cancer screening programs in other nations.

In this project, the benefits, harms and costs of implementing lung cancer screening policies in the province of Ontario, Canada, will be investigated, using the MISCAN-Lung microsimulation model. To accurately assess the harms and costs of implementing lung cancer screening, detailed information on the occurrence of follow-up procedures is required. Currently, the Computed Tomography (CT) arm of the NLST provides the best available information on the occurrence of follow-up procedures in lung cancer screening programs.

Therefore, we aim to use data from the CT arm of the NLST to obtain detailed information on the types and frequencies of follow-up procedures related to lung cancer CT screening. This detailed information will be used in conjunction with Ontario specific costs and smoking behavior estimates to update the MISCAN-Lung model, which will be used to investigate the effects of implementing lung cancer screening policies in Ontario.

References:
1. de Koning HJ, Meza R, Plevritis SK, et al. Benefits and Harms of Computed Tomography Lung Cancer Screening Strategies: A Comparative Modeling Study for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2014;160(5):311-320.
2. McMahon PM, Meza R, Plevritis SK, et al. Comparing Benefits from Many Possible Computed Tomography Lung Cancer Screening Programs: Extrapolating from the National Lung Screening Trial Using Comparative Modeling. PLoS ONE 2014;9(6):e99978.
3. Moyer VA. Screening for Lung Cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine 2014;160(5):330-338.
4. Aberle DR, Adams AM, Berg CD, et al. Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. New England Journal of Medicine 2011;365(5):395-409.