Abstract
Introduction: A lung cancer screening program is under consideration in Norway. However, the long-term clinical impacts and cost-effectiveness of low-dose computed tomography (LDCT) screening for lung cancer remain unclear. Our aim was to estimate the costs, health outcomes, and cost-effectiveness of lung cancer screening among high-risk ever-smokers in Norway. Methods: To assess the cost-effectiveness of lung cancer screening, we developed a deterministic, multi-cohort model that utilized data from the NELSON study, and Norwegian data on lung cancer mortality, risk, stage distribution, eligible smoking population, and resource use with associated costs. We calculated incremental cost-effectiveness ratios (ICERs) over a remaining lifetime horizon from an extended Norwegian healthcare perspective. Results: The ICERs for lung cancer screening compared to no screening were NOK 173,567 per life year saved and NOK 211,931 per quality-adjusted life year gained. Sensitivity analysis revealed that the ICERs were sensitive to assumptions regarding screening-related lung cancer mortality benefits during the screening and after-trial periods. Conclusion: The obtained results suggest that lung cancer screening with LDCT for high-risk ever-smokers may be cost-effective in Norway.