Cost-Effectiveness Analysis of Lung Cancer Screening in the United States
Authors: Robert P. Young, Raewyn J. Hopkins
Journal: Annals of Internal Medicine (2020)

Letters19 May 2020Cost-Effectiveness Analysis of Lung Cancer Screening in the United StatesRobert P. Young, MD, PhD and Raewyn J. Hopkins, BN, MPHRobert P. Young, MD, PhDUniversity of Auckland, Auckland, New Zealand (R.P.Y., R.J.H.)Search for more papers by this author and Raewyn J. Hopkins, BN, MPHUniversity of Auckland, Auckland, New Zealand (R.P.Y., R.J.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0071 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In a cost-effectiveness analysis of lung cancer screening, Criss and colleagues (1) concluded that screening persons older than 77 years was less cost-effective because this population has a shorter life expectancy from smoking-related comorbid conditions and fewer treatment options. Cheung and associates (2) suggest that including older persons, who have a shorter life expectancy because of multiple comorbidities, might inadvertently limit the population benefit of screening. Here we outline the unifying explanation underlying these 2 findings.In post hoc analyses of the NLST (National Lung Screening Trial), we have shown that airflow limitation—which defines chronic obstructive pulmonary ...References1. Criss SD, Cao P, Bastani M, et al. Cost-effectiveness analysis of lung cancer screening in the United States. A comparative modeling study. Ann Intern Med. 2019;171:796-804. [PMID: 31683314]. doi:10.7326/M19-0322 LinkGoogle Scholar2. Cheung LC, Berg CD, Castle PE, et al. Life-gained–based versus risk-based selection of smokers for lung cancer screening. Ann Intern Med. 2019;171:623-632. [PMID: 31634914]. doi:10.7326/M19-1263 LinkGoogle Scholar3. Hopkins RJ, Duan F, Chiles C, et al. Reduced expiratory flow rate among heavy smokers increases lung cancer risk. Results from the National Lung Screening Trial-American College of Radiology Imaging Network cohort. Ann Am Thorac Soc. 2017;14:392-402. [PMID: 28076701] doi:10.1513/AnnalsATS.201609-741OC CrossrefMedlineGoogle Scholar4. Shavelle RM, Paculdo DR, Kush SJ, et al. Life expectancy and years of life lost in chronic obstructive pulmonary disease: findings from the NHANES III Follow-up Study. Int J Chron Obstruct Pulmon Dis. 2009;4:137-148. [PMID: 19436692] CrossrefMedlineGoogle Scholar5. Young RP, Hopkins RJ. Chronic obstructive pulmonary disease (COPD) and lung cancer screening. Transl Lung Cancer Res. 2018;7:347-360. [PMID: 30050772] doi:10.21037/tlcr.2018.05.04 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Auckland, Auckland, New Zealand (R.P.Y., R.J.H.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0071. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness Analysis of Lung Cancer Screening in the United States Steven D. Criss , Pianpian Cao , Mehrad Bastani , Kevin ten Haaf , Yufan Chen , Deirdre F. Sheehan , Erik F. Blom , Iakovos Toumazis , Jihyoun Jeon , Harry J. de Koning , Sylvia K. Plevritis , Rafael Meza , and Chung Yin Kong Cost-Effectiveness Analysis of Lung Cancer Screening in the United States Steven D. Criss , Harry J. de Koning , Sylvia K. Plevritis , Rafael Meza , and Chung Yin Kong Metrics Cited byEconomic analysis of financial incentives for smoking cessation during pregnancy and postpartum 19 May 2020Volume 172, Issue 10Page: 705-706KeywordsCancer screeningChronic obstructive pulmonary diseaseComputed axial tomographyDisclosureLife expectancyLung and intrathoracic tumorsLung cancer screeningRespiratory system proceduresSpirometrySurgery ePublished: 19 May 2020 Issue Published: 19 May 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...