Cost-effectiveness of one-off upper abdominal CT screening as an add-on to lung cancer screening in England
Year: 2025
Type: article
Abstract: 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.
Source: British Journal of Cancer
Authors: 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, on behalf of the YKST Study Group, 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
Institutions: University of Sheffield, London School of Hygiene & Tropical Medicine, University of Leeds, Leeds Teaching Hospitals NHS Trust, University of Cambridge, Cancer Research UK Cambridge Center, University of Warwick, University of Manchester, University of Bradford, Portiuncula Hospital, Falmouth Hospital, Gabba Dermatology, University of Exeter
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $5,190
Awards: G2367376091, G242731019, G2493601830, G2537968379, G2830747971, G3119561655, G4268089617, G4655236649, G4995451912, G510844398, G5167650663, G5364368985, G5495922725, G5578676202, G5741036609, G6052482428, G6518889767, G6541669631, Developing a strategy for implementation of risk stratification into bowel cancer screening programmes, G7782972677, G8683158713
OpenAlex ID: W4410370376