Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects

Sébastien Gendarme, Jean-Claude Pairon (), Pascal Andujar (), François Laurent, Patrick Brochard, Fleur Delva, Bénédicte Clin, Antoine Gislard, Christophe Paris (), Isabelle Thaon (), Helene Goussault, Florence Canoui-Poitrine () and Christos Chouaïd ()
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Sébastien Gendarme: CHIC - Centre Hospitalier Intercommunal de Créteil, IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CEpiA - Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Jean-Claude Pairon: IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France
Pascal Andujar: IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France
François Laurent: CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] - UB - Université de Bordeaux - CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux - INSERM - Institut National de la Santé et de la Recherche Médicale
Patrick Brochard: CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux, EPICENE - Cancer environnement - BPH - Bordeaux population health - UB - Université de Bordeaux - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - INSERM - Institut National de la Santé et de la Recherche Médicale
Fleur Delva: EPICENE - Cancer environnement - BPH - Bordeaux population health - UB - Université de Bordeaux - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - INSERM - Institut National de la Santé et de la Recherche Médicale
Bénédicte Clin: CHU Caen - NU - Normandie Université - TCBN - Tumorothèque de Caen Basse-Normandie, UNICAEN - Université de Caen Normandie - NU - Normandie Université
Antoine Gislard: ABTE - Aliments Bioprocédés Toxicologie Environnements - UNICAEN - Université de Caen Normandie - NU - Normandie Université - UNIROUEN - Université de Rouen Normandie - NU - Normandie Université, CHU Rouen - NU - Normandie Université
Christophe Paris: CHIC - Centre Hospitalier Intercommunal de Créteil
Isabelle Thaon: CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
Helene Goussault: IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France
Florence Canoui-Poitrine: IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil] - IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Christos Chouaïd: CHIC - Centre Hospitalier Intercommunal de Créteil, U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil] - IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12

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Abstract: Background: The National Lung Screening Trial (NLST) and NELSON study opened the debate on the relevance of lung cancer (LC) screening in subjects exposed to occupational respiratory carcinogens. This analysis reported the incremental cost-effectiveness ratios (ICER) of an organized LC screening program for an asbestos-exposed population. Methods: Using Markov modelization, individuals with asbestos exposure were either monitored without intervention or annual low-dose thoracic computed-tomography (LDTCT) scan LC screening. LC incidence came from a prospective observational cohort of subjects with occupational asbestos exposure. The intervention parameters were those of the NLST study. Utilities and LC-management costs came from published reports. A sensitivity analysis evaluated different screening strategies. Results: The respective quality-adjusted life year (QALY) gain, supplementary costs and ICER [95% confidence interval] were: 0.040 [0.010–0.065] QALY, 6900 [3700–11,800] € and 170,000 [75,000–645,000] €/QALY for all asbestos-exposed subjects; and 0.144 [0.071–0.216] QALY, 13,000 [5700–26,800] € and 90,000 [35,000–276,000] €/QALY for smokers with high exposure. When screening was based on biennial LDTCT scans, the ICER was 45,000 [95% CI: 15,000–116,000] €/QALY. Conclusions: Compared to the usual ICER thresholds, biennial LDTCT scan LC screening for smokers with high occupational exposure to asbestos is acceptable and preferable to annual scans.

Keywords: lung neoplasms; screening; occupational diseases; asbestos; cost-effectiveness (search for similar items in EconPapers)
Date: 2022-08-24
New Economics Papers: this item is included in nep-hea
Note: View the original document on HAL open archive server: https://hal.science/hal-03783819v1
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Published in Cancers, 2022, 14 (17), pp.4089. ⟨10.3390/cancers14174089⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03783819

DOI: 10.3390/cancers14174089

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