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The National Lung Screening Trial (NLST) demonstrated that computed tomography (CT) screening lowered lung cancer–related mortality. Because the mortality difference (1.66% in a control group vs. 1.33% with CT screening) was relatively modest and screening is relatively expensive, the cost-effectiveness of screening has become a key issue for policy-makers and healthcare systems.
This cost-effectiveness analysis was based on NLST outcomes and Medicare costs. Averaged across the entire screened population, life was extended by 0.0316 years per person. The incremental cost of screening (which included the cost of CT plus downstream costs of evaluation and treatment) was US$1631 per person. Thus, the cost per life-year gained was $52,000 ($1631…