Cost-Effectiveness of Universal Low-Dose Computed Tomographic Lung Cancer Screening in Singapore

Is low-dose computed tomographic lung cancer screening cost-effective in Singapore when extended to include individuals who have never smoked?In this economic evaluation using a Markov cohort model, targeted ever smoker screening was highly cost-effective (incremental cost-effectiveness ratio below 9000 Singapore dollars [SGD] [US $6716] per quality-adjusted life-year [QALY]) but reached only approximately 8% of males and 2% of females. Extending to universal biennial screening yielded sequential incremental cost-effectiveness ratios of SGD 86 312/QALY (US $64 412/QALY) for males and SGD 80 881/QALY (US $60 359/QALY) for females.These findings suggest that biennial screening including never smokers falls below conventional cost-effectiveness thresholds and warrants consideration in Singapore.

Corresponding Author: Ruijie Li, PhD, MSc, Health Services and Outcomes Research, National Healthcare Group, National Skin Centre, 1 Mandalay Rd, Singapore 308205 (ruijie.li@nhghealth.com.sg).

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