IARC 60th Anniversary - 19-21 May 2026
Session : 21/05/26 - Posters
Health economic evaluations of lung cancer screening: a systematic review
CHEN N. 1,2, WANG S. 3, BAI J. 1,4, FRANCHINI F. 2, WINN K. 5, JINGYI H. 1, WANG J. 1, CHEN G. 2,6
1 Wuhan University, Wuhan, China; 2 University of Melbourne, Melbourne, Australia; 3 University of New South Wales, Sydney, Australia; 4 Yale University, New Haven, United States; 5 Monash University, Melbourne, Australia; 6 Peter MacCallum Cancer Centre, Melbourne, Australia
Background
Clinical trials have demonstrated the benefits of early detection of lung cancer (LC); however, the implementation of national LC screening programs remains under consideration. Economic evaluations provide evidence-based insights to support informed policy decisions.
Objectives
This systematic review aims to comprehensively synthesize the health economic evidence on LC screening and to examine the quality of the modeling approaches employed.
Methods
We searched six databases (Medline, Embase, Web of Science, the Cochrane Library, EconLit, and Scopus) from inception to July 31, 2025. Articles were included if evaluating LC screening using a full economic evaluation and/or budget impact analysis (BIA). The Criteria for Health Economic Quality Evaluation (CHEQUE) tool was used for quality assessment of full economic evaluations. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were modified as a quality checklist for BIA studies. Narrative synthesis was conducted to summarize the included studies.
Results
Ninety-five articles were identified, representing 93 full economic evaluations and 9 BIAs. Seventy-six full economic evaluations supported the cost-effectiveness of LC screening, 5 indicated it was not cost-effective, and 12 reported mixed results. Sixty studies evaluated low-dose computed tomography (LDCT) screening compared to no screening. Twelve studies considered emerging technologies as independent screening tests or complementary approaches to LDCT, including artificial intelligence, genomics, and biomarkers. All BIAs assessed LDCT-based LC screening program. Eight studies found that it would increase budget, while 1 reported the opposite when combined with immunotherapy treatment.
Conclusions
LDCT screening is cost-effective in high-risk populations, and emerging technologies have the potential to serve as valuable adjuncts to LDCT. Implementing LC screening programs may increase health system expenditures, though advanced treatments may offset expenditure. Further research is needed to evaluate the effectiveness and cost-effectiveness of combining LDCT with emerging technologies or therapies. The review provides up-to-date economic evidence on LC screening and offers policymakers a clearer understanding of its financial implications.