OBJECTIVE
To perform cost-effectiveness analysis of low-dose computed tomography for lung cancer screening instead of fluorography at the first stage of preventive medical examination (dispanserization) in high risk people; to study the population effects of the updated dispanserization program.
MATERIAL AND METHODS
We assessed the number of people with higher risk of lung cancer, calculated a new tariff for dispanserization and additional funding for implementation of low-dose computed tomography. Population clinical effects of preventive medical examination including low-dose computed tomography were predicted. We analyzed the role of updated medical examination in achieving the target indicators of the Federal Project «Fighting Oncological Diseases». All calculations were carried out for four scenarios: 100%, 75% and 50% participation rate, as well as 75—100% participation rate without increasing detection of lung cancer.
RESULTS
Target population in the Russian Federation may be up to 5.192.574 people. As a part of annual dispanserization, from 1.162.833 to 2.442.956 people with high risk of lung cancer should be examined in 2023. Examination of these persons including low-dose computed tomography will require additional funding of 1.265.394.871 to 2.658.424.719 rubles. Screening with low-dose computed tomography can improve detection of lung cancer up to 4.529 people (+9.2%), percentage of lung malignancies stage I will increase by 5.3—8.3%, one-year mortality will decrease by 7.8—11.34%, crude mortality will decrease by 2.62—3.63 cases per 100 thousand. From 3.847 to 5.331 deaths will be prevented. These processes will significantly influence on overall indicators of care for all malignant neoplasms and accelerate achievement of target indicators of the Federal Project «Fighting Oncological Diseases».
CONCLUSION
Cost-effectiveness analysis of lung cancer screening using low-dose computed tomography was carried out. We assessed potential clinical effects of medical technology and economic consequences of its implementation. These results can be used when considering the possibility of low-dose computed tomography instead of fluorography for lung cancer screening in people with high risk of lung malignancies.
