Abstract
Assessment of Biomarker Testing for Lung Cancer Screening Eligibility
Highlights
The National Lung Screening Trial (NLST) demonstrated that screening by low-dose computed tomography can reduce lung cancer mortality.[1]
In the smoking-model reference scenario, assuming screening of 9.0 million ever smokers, 62% of the future lung cancer cases occurring among all 43.4 million US ever smokers were classified as screening eligible
The Incremental cost-effectiveness ratios (ICERs) for biomarker-informed eligibility varied with the percentage of future cases classified as screening eligible and the per-person cost for biomarker testing (Figure)
Summary
The National Lung Screening Trial (NLST) demonstrated that screening by low-dose computed tomography can reduce lung cancer mortality.[1] benefits and harms depend on individual lung cancer risk, with benefit concentrated among high-risk individuals.[2] Risk prediction models can identify high-risk individuals, but their performance is limited by reliance on assessable risk factors such as age and smoking history.[3,4] Incorporating information from biomarkers could further improve risk assessment,[5] allowing more deaths to be prevented. We explored whether incorporating biomarkers into eligibility assessment for lung screening might be cost-effective.
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