Financial concerns are a major part of medical care policy in the U.S. today. Treatments that do not meet current standards for value and cost-effectiveness are not approved by health insurance companies.
Measurement of cost-effectiveness in lung cancer screening has provided widely varying results. Measured in QALYs, the cost of producing a year of quality life, the results vary between more than a million dollars to less than $15,000. Studies based upon accurate, modern research results show cost-effectiveness as good or better than those measured in other forms of cancer screening or treatment.
This result is more striking when compared with the costs of treatment of lung cancer in patients who are not screened. Two facts are indisputable.
1. The cost of treatment of advanced stage lung cancer is enormous.
2. Curative benefit is very limited.
Although there have been improvements in duration of survival and quality of life, treatment of lung cancer in stage IV remains very expensive. Some current chemotherapy treatments cost as much as $240,000. Unfortunately, long-term cure is uncommon..
In contradistinction, treatment of lung cancer detected in early stage by CT screening is inexpensive and highly effective. In stage I, where most lung cancers are discovered by screening, treatment with either surgical resection or radiation therapy is much less expensive than treatment in advanced stages and is highly effective.
Following surgical resection of screen-detected lung cancer, cure is seen in 80% or higher. In most cases no adjuvant (added) treatment with chemotherapy is needed.
A further benefit of screening is that most lung cancers detected by screening can be removed using minimally-invasive surgical methods that often preserve more lung tissue. Patients treated with these methods typically have low complications, low risk of death and earlier time to hospital discharge and recovery.
Lung cancer screening does not divert resources; it preempts advanced stage disease and saves resources that otherwise would be spent on expensive and largely ineffective chemotherapy.
Lung cancer screening saves lives and dollars.