This study assessed the cost-effectiveness of a lung cancer screening (LCS) program using low-dose computed tomography (LDCT) in Austria. An existing decision tree with an integrated Markov model was used to analyze the cost-effectiveness of LCS versus no screening from a healthcare payer perspective over a lifetime horizon. A simulation was conducted to model annual LCS for an asymptomatic high-risk population cohort aged 50–74 with a smoking history using the Dutch–Belgian Lung Cancer Screening Study (NEderlands-Leuvens Longkanker ScreeningsONderzoek, NELSON) screening outcomes. The principal measure utilized to assess cost-effectiveness was the incremental cost-effectiveness ratio (ICER). Sensitivity and scenario analyses were employed to determine uncertainties surrounding the key model inputs. At an uptake rate of 50%, 300,277 eligible individuals would participate in the LCS program, yielding 56,122 incremental quality-adjusted life years (QALYs) and 84,049 life years gained compared to no screening, with an ICER of EUR 24,627 per QALY gained or EUR 16,444 per life-year saved. Additionally, LCS led to the detection of 25,893 additional early-stage lung cancers and averted 11,906 premature lung cancer deaths. It was estimated that LCS would incur EUR 945 million additional screening costs and EUR 386 million additional treatment costs. These estimates were robust in sensitivity analyses. Implementation of annual LCS with LDCT for a high-risk population, using the NELSON screening outcomes, is cost-effective in Austria, at a threshold of EUR 50,000 per QALY.
本研究评估了奥地利采用低剂量计算机断层扫描（LDCT）进行肺癌筛查（LCS）项目的成本效益。通过整合马尔可夫模型的决策树，从医疗支付方角度，对终身范围内实施LCS与不筛查方案进行了成本效益分析。研究基于荷兰-比利时肺癌筛查研究（NELSON）的筛查结果，模拟了对50-74岁有吸烟史的无症状高风险人群进行年度LCS的情况。成本效益评估主要采用增量成本效益比（ICER）作为衡量指标，并通过敏感性分析和情景分析以确定关键模型参数的不确定性。在50%参与率下，预计将有300,277名符合条件者参与LCS项目，与不筛查相比，可增加56,122个质量调整生命年（QALYs）和84,049个生命年，每获得一个QALY的ICER为24,627欧元，每挽救一个生命年的成本为16,444欧元。此外，LCS可额外检出25,893例早期肺癌，避免11,906例过早肺癌死亡。预计LCS将产生9.45亿欧元的额外筛查成本和3.86亿欧元的额外治疗成本，这些估计值在敏感性分析中保持稳健。研究表明，在奥地利采用NELSON筛查结果对高风险人群实施年度LDCT肺癌筛查具有成本效益，其成本效益阈值低于每QALY 50,000欧元。
肿瘤(癌症)患者之家