A new study by the Daffodil Centre, published in the British Journal of Cancer, has strengthened the economic case for a targeted lung cancer screening program in Australia.
The study updates cost-effectiveness estimates in an Australian context, based on the findings of two major international trials of lung cancer screening, the Dutch-Belgian NELSON trial and the U.S. National Lung Screening Trial.
A/Professor Marianne Weber, leader of the Daffodil Centre’s Lung Cancer Policy and Evaluation Stream, said the study showed that if trial results were adapted into the Australian health system, lung cancer screening for Australians with a history of heavy smoking would have a favourable cost-effectiveness ratio, given updated evidence on the benefits of screening and costs of lung cancer care.
She said the results helped inform the recommendation to government from the independent Medical Services Advisory Committee (MSAC) announced earlier this month, which supported the implementation of a targeted national lung cancer screening program.
“The greatest challenge in cancer screening is ensuring that it delivers more benefit than harm to the population,” A/Professor Weber said. “For most cancers, unfortunately there are not yet tests for asymptomatic populations that work without causing significant harms, such as inaccurate results that lead to unnecessary diagnostic tests and treatments, stress for the individuals affected and out-of-pocket costs.
“Governments also consider cost-effectiveness as a matter of course. Our results show that targeted lung cancer screening using low-dose computed tomography could be more cost-effective than previous estimates had indicated, which strengthens the economic case for a targeted lung cancer screening program.”
Professor Karen Canfell, Director of the Daffodil Centre and senior author on the study, said that Australia was a world leader in cancer screening, yet opportunities for optimal screening outcomes were not always realised.
“Australia is on track to be the first country to eliminate cervical cancer through a combination of immunisation, screening and treatment, and our bowel and breast cancer screening programs are among the world’s best,” Professor Canfell said.
“The overseas NELSON trial (Dutch-Belgian) and National Lung Screening Trial (USA) both showed lives could be saved by lung cancer screening. However, translating those results will require a focus on optimal implementation to ensure a new lung screening program reaches those who will benefit and that it operates effectively within Australia’s unique health system.
“The key will be for government to continue to work with independent researchers and other stakeholders in considering optimal policy and practice for the early detection of lung cancer, Australia’s leading cause of cancer death.”
Australia has the potential to reduce lung cancer deaths by up to 24% if outcomes from international trials can be duplicated and realised successful in local health systems.
“We support continued investment in work to enhance the cost-effectiveness and success of a targeted lung cancer screening program in Australia.” A/Professor Weber concluded.
This paper is only one component of a broader program of work at the Daffodil Centre which aims to reduce the impact of lung cancer in Australia.