Quantifying The Value of Reduced Health Disparities: Low-Dose CT Lung Cancer Screening of High-Risk Individuals within the US

Jason Shafrin, Ph.D., Senior Managing Director, Jaehong Kim, Ph.D., Director, and Moises Marin, Senior Consultant, recently published an article quantifying the value of increasing lung cancer screening rates for high-risk individuals and its impact on health disparities. The article was published in Value in Health and is titled “Quantifying The Value of Reduced Health Disparities: Low-Dose CT Lung Cancer Screening of High-Risk Individuals within the US.” The study abstract is below.

ABSTRACT

Objective

To measure the value of increasing lung cancer screening rates for high-risk individuals and its impact on health disparities.

Methods

The model estimated changes in health economic outcomes if low-dose computed tomography (LDCT) screening increased from current to 100% compliance, following clinical guidelines. Current LDCT screening rates were estimated by income, education and race, using 2017-2019 Behavioral Risk Factor Surveillance System data. The model contained a decision tree module to segment the population by screening outcomes and a Markov chain module to estimate cancer progression over time. Model parameters included information on survival, quality-of-life, and costs related to cancer diagnosis, treatment, and adverse events. Distributional cost-effectiveness analysis (DCEA) estimated the net monetary value from reduced health disparities—measured using quality adjusted life expectancy (QALE)—across income, education and race groups. Outcomes were assessed over 30 years.

Results

Lung cancer screening eligibility using US Preventative Services Task Force (USPSTF) guidelines was higher for individuals with income <$15,000 (47.2%) and without a high-school education (46.1%), compared to individuals with income >$50,000 (16.6%) and with a college degree (13.5%), respectively. Increasing lung cancer screening to 100% compliance was cost-effective ($64,654 per QALY) and produced economic value by up to $560 per person ($182.1 billion for US overall). Up to 32.2% of the value was due to reductions in health disparities.

Conclusion

Significant value in increasing lung cancer screening rates derived from reducing health disparities. Policymakers and clinicians may not be appropriately prioritizing cancer screening if value from reducing health disparities are unconsidered.

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Key Contacts

Jason Shafrin, Ph.D.
Senior Managing Director