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Título:	Health and economic impact at a population level of both primary and secondary preventive lung cancer interventions: A model-based cost-effectiveness analysis
Autor/a:	Diaz, Mireia; Garcia, Montse; Vidal, Carmen; Santiago, Albert; Gnutti, Gerard; Gomez, David; Trapero Bertran, Marta; Fu, Marcela; Lung Cancer Prevention LUCAPREV Research Group
Notas:	Objectives: Robust economic evaluations are needed to identify efficient strategies for lung cancer prevention that combine brief and intensive smoking cessation intervention programmes with screening using low-dose computed tomography (LDCT) at different ages, frequencies, and coverages. We aimed to assess the cost-effectiveness of smoking cessation approaches combined with lung cancer screening in the European context at a population level from a societal perspective. Materials and Methods: A microsimulation model that describes the natural history of lung cancer and incorporates several prevention strategies was developed. Discounted lifetime QALYs and costs at a rate of 3% were used to calculate incremental cost-effectiveness ratios, defined as additional costs in 2017 Euros per QALY gained. Results: Smoking cessation interventions reduce the incidence of lung cancer by 8%-46% and are consistently more effective and cost-effective when starting at younger ages. Screening reduces lung cancer mortality by 1%-24% and is generally less effective and more costly than smoking cessation interventions. The most cost-effective strategy would be to implement intensive smoking cessation interventions at ages 35, 40 and 45, combined with screening every three years between the ages of 55 and 65. Conclusions: Combining smoking cessation interventions with LDCT screening is a very attractive prevention strategy that substantially diminishes the burden of lung cancer. These combined prevention strategies, especially when providing several intensive interventions for smoking cessation at early ages, are more cost-effective than both approaches separately and allow for a more intensified LDCT without losing efficiency.
Materia(s):	-Rendibilitat -Deixar de fumar -Intervenció intensiva per deixar de fumar -Càncer de pulmó -Cribratge LDCT -Rentabilidad -Dejar de fumar -Intervención intensiva para dejar de fumar -Cáncer de pulmón -Cribado LDCT -Profitability -Stop smoking -Intensive intervention to stop smoking -Lung cancer -LDCT screening -61
Derechos:	© 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). http://creativecommons.org/licenses/by-nc-nd/4.0/
Tipo de documento:	Artículo Artículo - Versión publicada
Editor:	Elsevier
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