COST-EFFECTIVENESS OF CT SCREENING IN THE NATIONAL LUNG SCREENING TRIAL (Black et al, NEJM 2014; 371: 1793-1802)
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Summary: Low dose CT screening for lung cancer would cost $81,000 per QALY gained. It is most cost effective in women and in highest risk groups (i.e. current smokers & older age).
LUNG CANCER PROBABILITY IN PATIENTS WITH CT-DETECTED PULMONARY NODULES: A PRESPECIFIED ANALYSIS OF DATA FROM THE NELSON TRIAL OF LOW-DOSE CT SCREENING (Horeweg et al, Lancet Oncol 2014; 15 (12):1332-41)
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Volume, volume doubling time, and volumetric-based diameter of 9681 non-calcified nodules detected by CT screening in 7155 participants in the screening group of NELSON were used to quantify lung cancer probability. Small nodules (those with a volume <100mm³ or diameter < 5mm) are not predictive for lung cancer. Immediate diagnostic evaluation is necessary for large nodules (>300mm³ or >10mm). Volume doubling time assessment is advocated only for intermediate-sized nodules (volume 100 – 300mm³ or 5 – 10mm).
Summary: Nodule size and volume doubling time are used to determine an individuals’ lung cancer probability.