Computed tomography screening for lung cancer in Hodgkin's lymphoma survivors: Decision analysis and cost-effectiveness analysis

Praj Das, A. K. Ng, C. C. Earle, P. M. Mauch, K. M. Kuntz

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Background: Hodgkin's lymphoma patients have an elevated risk of developing lung cancer and may be targeted for lung cancer screening. We used a decision-analytic model to estimate the potential clinical benefits and cost-effectiveness of computed tomography (CT) screening for lung cancer in Hodgkin's lymphoma survivors. Materials and methods: We developed a Markov decision-analytic model to compare annual low-dose CT screening versus no screening in a hypothetical cohort of patients diagnosed with stage IA-IIB Hodgkin's lymphoma at age 25, with screening starting 5 years after initial diagnosis. We derived model parameters from published studies and the Surveillance, Epidemiology and End Results (SEER) Program, and assumed that stage-shift produces a survival benefit. Results: Annual CT screening increased survival by 0.64 years for smokers and 0.16 years for non-smokers. The corresponding benefits in quality-adjusted survival were 0.58 quality-adjusted life-years (QALYs) for smokers and 0.14 QALYs for non-smokers. The incremental cost-effectiveness ratios for annual CT screening compared with no screening were $34 100/QALY for smokers and $125400/QALY for non-smokers. Conclusions: Our analysis suggests that if early promising results for lung cancer screening hold, CT screening for lung cancer may increase survival and quality-adjusted survival among Hodgkin's lymphoma survivors, with a benefit and incremental cost-effectiveness ratio for smokers comparable to that of other recommended cancer screening strategies.

Original languageEnglish (US)
Pages (from-to)785-793
Number of pages9
JournalAnnals of Oncology
Volume17
Issue number5
DOIs
StatePublished - May 1 2006

Keywords

  • Cost-effectiveness
  • Decision analysis
  • Hodgkin's lymphoma
  • Lung cancer
  • Second malignancies

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