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Low-Dose Computed Tomography for Lung Cancer Screening: A Review of the Clinical Effectiveness, Diagnostic Accuracy, Cost-Effectiveness, and Guidelines

Last updated: September 22, 2015
Project Number: RC0706-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the diagnostic accuracy of low-dose computed tomography for lung cancer screening in high-risk populations?
  2. What is the clinical effectiveness and safety of low-dose computed tomography for lung cancer screening in high-risk populations?
  3. What is the cost-effectiveness of low-dose computed tomography for lung cancer screening in high-risk populations?
  4. What are the evidence-based guidelines regarding the use of low-dose computed tomography for lung cancer screening?

Key Message

The sensitivity and specificity with low-dose computed tomography (LDCT) were, respectively, 93.8% and 73.4%. The positive predictive value ranged between 2.4% to 4.4%. The negative predictive value was 99.9%.Screening with LDCT resulted in detection of early-stage lung cancers and reduced cancer-related mortality. However, the high rate of false positives can lead to harm from unnecessary work-up of benign nodules. The incremental cost-effectiveness ratio (cost per QALY gained) for screening with LDCT varied between US$11,252 and US$795,685 in North American settings, depending on the scenario. The evidence-based guidelines recommended, annual lung cancer screening with LDCT for people with a smoking history of at least 30 pack-years and who currently smoke or have quit within the last 15 years.