ArticleBMC medicine2017
Trade-off between benefits, harms and economic efficiency of low-dose CT lung cancer screening: a microsimulation analysis of nodule management strategies in a population-based setting.
Article in BMC medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
26 citing papers in PubMed, 7 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Cost-Effectiveness and Budget Impact of Lung Cancer Screening: A Systematic Review.PharmacoEconomics · 2026Pooled it
- Screening for lung cancer: A systematic review of overdiagnosis and its implications.Molecular oncology · 2026Pooled it
- Cost-effectiveness of lung cancer screening: insights from risk stratification, guidelines, and emerging technologies-a systematic review.NPJ primary care respiratory medicine · 2026Pooled it
- Software with artificial intelligence-derived algorithms for detecting and analysing lung nodules in CT scans: systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2025Pooled it
- Population-Based Screening Using Low-Dose Chest Computed Tomography: A Systematic Review of Health Economic Evaluations.PharmacoEconomics · 2023Pooled it
- EarlyCDT Lung blood test for risk classification of solid pulmonary nodules: systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2022Pooled it
- Cost-Effectiveness Analyses of Lung Cancer Screening Using Low-Dose Computed Tomography: A Systematic Review Assessing Strategy Comparison and Risk Stratification.PharmacoEconomics - open · 2022Pooled it
- Health economic evaluation of health promotion and disease prevention in Germany: a scoping review.Health economics review · 2026Review
- Structured narrative review on lung cancer screening: current evidence, clinical practice implications and implementation insights from a multidisciplinary task force and patient representatives.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Natural history models for lung Cancer: A scoping review.Lung cancer (Amsterdam, Netherlands) · 2025Article
- Pilot study of lung cancer screening for survivors of Hodgkin lymphoma.Haematologica · 2024Article
- Shall We Screen Lung Cancer with Volume Computed Tomography in Austria? A Cost-Effectiveness Modelling Study.Cancers · 2024Article
- Translating potential improvement in the precision and accuracy of lung nodule measurements on computed tomography scans by software derived from artificial intelligence into impact on clinical practice-a simulation study.BJR artificial intelligence · 2024Article
- Health Care Utilization and Costs in Lung Cancer Screening Participants-A Propensity-Matched Economic Analysis.JTO clinical and research reports · 2023Article
- Important parameters for cost-effective implementation of lung cancer screening.The British journal of radiology · 2023Review
- Volume doubling time and radiomic features predict tumor behavior of screen-detected lung cancers.Cancer biomarkers : section A of Disease markers · 2022Article
- Contemporary issues in the implementation of lung cancer screening.European respiratory review : an official journal of the European Respiratory Society · 2021Review
- Lung cancer screening: who pays? Who receives? The European perspectives.Translational lung cancer research · 2021Review
- Implementation of lung cancer screening: what are the main issues?Translational lung cancer research · 2021Review
- Risk prediction models versus simplified selection criteria to determine eligibility for lung cancer screening: an analysis of German federal-wide survey and incidence data.European journal of epidemiology · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn lung cancer screening, a nodule management protocol describes nodule assessment and thresholds for nodule size and growth rate to identify patients who require immediate diagnostic evaluation or additional imaging exams. The Netherlands-Leuvens Screening Trial and the National Lung Screening Trial used different selection criteria and nodule management protocols. Several modelling studies have reported variations in screening outcomes and cost-effectiveness across selection criteria and screening intervals; however, the effect of variations in the nodule management protocol remains uncertain. This study evaluated the effects of the eligibility criteria and nodule management protocols on the benefits, harms and cost-effectiveness of lung screening scenarios in a population-based setting in Germany.
methodsWe developed a modular microsimulation model: a biological module simulated individual histories of lung cancer development from carcinogenesis onset to death; a screening module simulated patient selection, screening-detection, nodule management protocols, diagnostic evaluation and screening outcomes. Benefits included mortality reduction, life years gained and averted lung cancer deaths. Harms were costs, false positives and overdiagnosis. The comparator was no screening. The evaluated 76 screening scenarios included variations in selection criteria and thresholds for nodule size and growth rate.
resultsFive years of annual screening resulted in a 9.7-12.8% lung cancer mortality reduction in the screened population. The efficient scenarios included volumetric assessment of nodule size, a threshold for a volume of 300 mm
conclusionsLung cancer screening can be cost-effective in Germany. Along with the eligibility criteria, the nodule management protocol influences screening performance and cost-effectiveness. Definition of the thresholds for nodule size and nodule growth in the nodule management protocol should be considered in detail when defining optimal screening strategies.
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