Risk model-based lung cancer screening more cost-effective than USPSTF guidelines
Using risk model-based strategies to determine who should undergo low-dose CT lung cancer screening is more cost effective than current U.S. Preventive Services Task Force (USPSTF) guidelines [1].
That’s according to new data published in Annals of Internal Medicine. The new paper highlights recent updates to the USPSTF recommendations that were made in 2021, but notes that those guidelines are still based solely on age and smoking history. Experts involved in the new work suggest that, although these guidelines are effective for some, they can be optimized for those who are most likely to benefit from lung cancer screenings using a risk model-based approach.
“Findings from this study could be considered as a potential guide for the development of cost-effective risk model-based lung cancer screening under various settings and availability of health care resources,” said lead author Iakovos Toumazis, PhD, assistant professor of Health Services Research at University of Texas MD Anderson Cancer Center. “While the current recommendations are cost effective, our findings suggest that we can improve on these guidelines and provide more flexibility to include those most likely to benefit from lung cancer screening.”
Currently, the USPSTF recommends low-dose CT lung cancer screenings for individuals who are 50 to 80-years-old and have history of smoking 20 packs of cigarettes per year, those who currently smoke and those who formerly smoked but have quit within the last 15 years.
Experts believe these recommendations can be improved with the use of risk calculator models. Specifically, they propose the use of two models—one that estimates a person’s six-year probability of developing lung cancer and one that predicts the likelihood of a person dying from lung cancer within the next six years.
The experts found that when using a 6-year risk threshold of 1.2% or greater, these models are more cost-effective than current USPSTF guidelines and they also yield more quality-adjusted life-years.
“Our model shows that personal risk-based screening for lung cancer is cost effective under a wide range of risk thresholds,” Toumazis said, adding that risk model-based methods should be considered in the future as they offer flexibility and can be implemented in settings with varying resources.
The study abstract is available here.