Lung cancer screening: who pays? Who receives? The European perspectives.

Content Provider	Europe PMC
Author	Novellis, Pierluigi Cominesi, Silvia Raimondi Rossetti, Francesca Mondoni, Michele Gregorc, Vanesa Veronesi, Giulia
Copyright Year	2021
Abstract	Lung cancer is the leading cause of cancer-related death worldwide, and its early detection is critical to achieving a curative treatment and to reducing mortality. Low-dose computed tomography (LDCT) is a highly sensitive technique for detecting noninvasive small lung tumors in high-risk populations. We here analyze the current status of lung cancer screening (LCS) from a European point of view. With economic burden of health care in most European countries resting on the state, it is important to reduce costs of screening and improve its effectiveness. Current cost-effectiveness analyses on LCS have indicated a favorable economic profile. The most recently published analysis reported an incremental cost-effectiveness ratio (ICER) of €3,297 per 1 life-year gained adjusted for the quality of life (QALY) and €2,944 per life-year gained, demonstrating a 90% probability of ICER being below €15,000 and a 98.1% probability of being below €25,000. Different risk models have been used to identify the target population; among these, the PLCOM2012 in particular allows for the selection of the population to be screened with high sensitivity. Risk models should also be employed to define screening intervals, which can reduce the general number of LDCT scans after the baseline round. Future perspectives of screening in a European scenario are related to the will of the policy makers to implement policy on a large scale and to improve the effectiveness of a broad screening of smoking-related disease, including cardiovascular prevention, by measuring coronary calcium score on LDCT. The employment of artificial intelligence (AI) in imaging interpretation, the use of liquid biopsies for the characterization of CT-detected undetermined nodules, and less invasive, personalized surgical treatments, will improve the effectiveness of LCS.
ISSN	22186751
Journal	Translational Lung Cancer Research
Volume Number	10
PubMed Central reference number	PMC8182705
Issue Number	5
PubMed reference number	34164287
e-ISSN	22264477
DOI	10.21037/tlcr-20-677
Language	English
Publisher	AME Publishing Company
Publisher Date	2021-05-01
Access Restriction	Open
Rights License	Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0. 2021 Translational Lung Cancer Research. All rights reserved.
Subject Keyword	Lung cancer screening (LCS) low-dose computed tomography (LDCT) risk models European LCS
Content Type	Text
Resource Type	Article
Subject	Oncology