Evidence map›Paper›PMID 40043061›Full record

ArticlePloS one2025

Lung cancer screening with volume computed tomography is cost-effective in Greece.

Xuanqi Pan, Katerina Togka, Hilde Ten Berge, Lisa de Jong, Harry Groen, Maarten J Postma, Eleftherios Zervas, Ioannis Gkiozos, Christoforos Foroulis, Kyriaki Tavernaraki and 5 more

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Xuanqi PanInstitute for Diagnostic Accuracy, Groningen, The Netherlands.ORCID https://orcid.org/0000-0001-5237-3544
Katerina TogkaInstitute for Diagnostic Accuracy, Groningen, The Netherlands.
Hilde Ten BergeInstitute for Diagnostic Accuracy, Groningen, The Netherlands.
Lisa de JongUnit of Global Health, Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands.
Harry GroenDepartment of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Maarten J PostmaUnit of Global Health, Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands.
Eleftherios Zervas7th Pneumonology Department, Sotiria Thoracic Diseases Hospital of Athens, Athens, Greece.ORCID https://orcid.org/0000-0001-7436-4550
Ioannis GkiozosThird Department of Internal Medicine, Sotiria General Hospital for Chest Diseases, National and Kapodistrian University of Athens, Athens, Greece.
Christoforos ForoulisDepartment of Cardiothoracic Surgery, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, Greece.
Kyriaki TavernarakiImaging and Interventional Radiology, Sotiria General and Chest Diseases Hospital, Athens, Greece.
Sofia LampakiDepartment of Pneumonology, "Papanikolaou" Hospital, Thessaloniki, Greece.
Georgia KourlabaDepartment of Nursing, Faculty of Health Sciences, University of Peloponnese, Tripoli, Greece.
Antonios MorarisExternal Affairs Department, AstraZeneca Greece, Athens, Greece.
Sofia AgelakiDepartment of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece.
Konstantinos SyrigosThird Department of Internal Medicine, Sotiria General Hospital for Chest Diseases, National and Kapodistrian University of Athens, Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to assess the cost-effectiveness of lung cancer screening (LCS) employing volume-based low-dose computed tomography (LDCT) in contrast to the absence of screening, targeting an asymptomatic high-risk population in Greece, leveraging the outcomes derived from the NELSON study, the largest European randomized control trial dedicated to LCS.

methodsA validated model incorporating a decision tree and an integrated state-transition Markov model was used to simulate the identification, diagnosis, and treatments for a population at high risk of developing lung cancer, from a healthcare payer perspective. Screen-detected lung cancers, costs, life years (LYs), quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) were predicted. Sensitivity and scenario analyses were conducted to assess the robustness and reliability of the model's outcomes under varying parameters and hypothetical situations.

resultsAnnual LCS with volume-based LDCT detected 17,104 more lung cancer patients at early-stage among 207,885 screening population, leading to 8,761 premature lung cancer deaths averted. In addition, in contrast to no screening, LCS yielded 86,207 LYs gained and 50,207 incremental QALYs at an additional cost of €278,971,940, resulting in an ICER of €3,236 per LY and €5,505 per QALY, over a lifetime horizon. These estimates were robust in sensitivity analyses.

conclusionsLCS with volume-based LDCT, targeting an asymptomatic high-risk population, is highly cost-effective in Greece. Implementing LCS ensures efficient allocation of public healthcare resources while delivering substantial clinical benefits to lung cancer patients.

Indexed as

Cost-Benefit AnalysisEarly Detection of CancerLung NeoplasmsTomography, X-Ray ComputedAgedFemaleGreeceHumansMaleMarkov ChainsMass ScreeningMiddle AgedQuality-Adjusted Life Years

Identifiers

PMID40043061
PMCPMC11882067

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.