Evidence map›Paper›PMID 40236262›Full record

ArticleJTO clinical and research reports2025

Model-Based Cost-Utility Analysis of Combined Low-Dose Computed Tomography Screening for Lung Cancer, Chronic Obstructive Pulmonary Disease, and Cardiovascular Disease.

Carina M Behr, Maarten J IJzerman, Michelle M A Kip, Harry J M Groen, Marjolein A Heuvelmans, Maarten van den Berge, Pim van der Harst, Marleen Vonder, Rozemarijn Vliegenthart, Hendrik Koffijberg

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In one paragraph

Article in JTO clinical and research reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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, 1 synthesis or guideline pooled it.

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

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Carina M BehrHealth Technology and Services Research, TechMed Centre, University of Twente, Enschede, The Netherlands.
Maarten J IJzermanHealth Technology and Services Research, TechMed Centre, University of Twente, Enschede, The Netherlands.
Michelle M A KipHealth Technology and Services Research, TechMed Centre, University of Twente, Enschede, The Netherlands.
Harry J M GroenDepartment of Pulmonary Diseases and Tuberculosis, UMCG - University Medical Center Groningen, Groningen, The Netherlands.
Marjolein A HeuvelmansDepartment of Epidemiology, University Medical Center of Groningen, University of Groningen, Groningen, The Netherlands.
Maarten van den BergeDepartment of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Pim van der HarstDepartment of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Marleen VonderDepartment of Epidemiology, University Medical Center of Groningen, University of Groningen, Groningen, The Netherlands.
Rozemarijn VliegenthartDepartment of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Hendrik KoffijbergHealth Technology and Services Research, TechMed Centre, University of Twente, Enschede, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The conditional cost-effectiveness of low-dose computed tomography for lung cancer (LC) screening has been reported. Extending LC screening to chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD), together with Big-3, could increase health benefits at marginal costs. This study aimed to estimate the cost-utility of Big-3 screening compared with no screening and LC screening in The Netherlands. Methods: A microsimulation model was built to reflect the care pathway, using individual-level data from the National Lung Screening Trial individual-level data, and aggregated data from the literature. The model includes a simulation of the detection of the Big-3 diseases through screening and standard of care. The model also simulated tumor growth and the effects of smoking cessation and treatment. Hypothetical (former) smokers (aged 55-74 y) were simulated according to the National Lung Screening Trial criteria. Individuals with screening-detected diseases receiving (preventative) treatment experience a reduced risk of events and increased survival. A Dutch health system perspective and lifetime horizon were adopted. Results: Simultaneous LC and CVD screening was the most cost-effective, with incremental costs and effects of €1937 and 0.22 quality-adjusted life-years (QALYs) versus no screening, and €595 and 0.08 QALYs versus LC screening, respectively. This yielded incremental cost-utility ratios of €8561 per QALY and €7154 per QALY versus no screening and LC screening, respectively. LC plus COPD screening was dominated by LC + CVD screening, which yielded lower health benefits and higher costs. Conclusions: Simultaneous screening for LC + CVD in a high-risk population offers health benefits at low costs compared with no screening or LC screening alone. Adding COPD screening cannot yet be justified owing to the limited clinical evidence.

Indexed as

Cardiovascular diseaseChronic obstructive pulmonary diseaseLow-dose computed tomographyLung cancerPopulation-based screening

Identifiers

PMID40236262
PMCPMC11998116

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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.