A Review and Meta-Analysis of Utility Values for Lung Cancer

Sturza, Julie

doi:10.1177/0272989x10369004

Cited by 68 publications

(81 citation statements)

References 57 publications

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“…Utility weights for the general population of males and females aged 50–59 and 60–69 were obtained from a study using the SF-6D and standard gamble technique in a nationally-representative sample [33]. Among patients diagnosed with lung cancer, stage, age and sex-specific utilities were multiplied by the utility of lung cancer by stage as determined from a meta-analysis of lung cancer utility weights [34]. Patients with screen-detected cancers were assigned QALYs at ages that accounted for a two-year detection lead time.…”

Section: Methodsmentioning

confidence: 99%

A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions

et al. 2013

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BackgroundA 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT) screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proof to financial feasibility. The goal of this study was to determine whether LDCT screening for lung cancer in a commercially-insured population (aged 50–64) at high risk for lung cancer is cost-effective and to quantify the additional benefits of incorporating smoking cessation interventions in a lung cancer screening program.Methods and FindingsThe current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs) gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses.ConclusionsThe findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50–64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical recommendations.

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Section: Methodsmentioning

confidence: 99%

A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions

et al. 2013

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“…For example, a patient with metastatic non-small cell lung cancer after treatment and after recurrence was assigned a utility modifier of 0.57 in the Villanti et al study [5] and 0.62 in the McMahon et al study [7,11,12]. This difference, though relatively small, leads to an increase in the estimated effectiveness of preventing cancer in the analysis of Villanti et al [5], which leads to an increase in the estimated QALYs gained and consequently a lower ICER.…”

Section: Inputs In Lung Cancer Screening Analysesmentioning

confidence: 99%

Understanding Cost-Effectiveness Analyses: An Explanation Using Three Different Analyses of Lung Cancer Screening

Curl

Kahn

Ordovás

et al. 2015

American Journal of Roentgenology

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“…A linear model was developed. The metaregression determined a collection of reference lung cancer utility values of 0.573, 0.772, and 0.823 for metastatic, mixed/not specified, and nonmetastatic NSCLC, respectively, with patient as respondent, Standard Gamble (SG) as method, and death to perfect health as bounds of the scale (20). In total, these studies demonstrate a lower quality of life for patients with lung cancer than we noted in the screening population and further decline in the quality of life with lung cancer-related symptoms, advancement of the disease, and treatments of late-stage disease.…”

Section: Original Researchmentioning

confidence: 99%

Quality of Life and Healthcare Use in a Randomized Controlled Lung Cancer Screening Study

Mazzone¹,

Obuchowski

et al. 2013

Annals ATS

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Rationale: Understanding the quality of life of lung cancer screening program participants, and the impact of program participation on quality of life and healthcare use, will help in the assessment of the value of screening.Objectives: Determine the quality of life of participants in a lung cancer screening study and assess the effect of an abnormal screening finding on quality of life and healthcare use.Methods: Quality-of-life measures and data on the use of healthcare services were collected prospectively during a randomized controlled lung cancer screening trial using chest radiography with computer-aided detection. Comparisons of baseline measures were made with U.S. population norms for the EuroQol 5-Dimension index. The impact of receiving a message of the presence of a lung nodule was assessed for all measures. Measurements and Main Results:A total of 1,424 subjects participated. Twenty-five actionable nodules were reported. Baseline EuroQol 5-Dimension index scores were higher than U.S. population norms (P , 0.0001). The EuroQol 5-Dimension index score and St. George's Respiratory Questionnaire symptom score showed a significant change toward poorer quality of life after notification of the presence of a lung nodule (0.940 vs. 0.877, P = 0.022, and 25.7 vs. 34.0, P = 0.005, respectively). Chest imaging within 6 months of the screening examination occurred more frequently in those notified of a lung nodule (25.5 vs. 9.3%, P = 0.002). Conclusions:Those who choose to enter a lung cancer screening program have a high baseline quality of life. The report of an abnormal screening finding can lower the quality of life and lead to increased chest imaging. Clinical trial registered with www.clinicaltrials.gov (NCT01663155).Keywords: computer-aided detection; lung nodules; EuroQol 5-Dimension

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A Review and Meta-Analysis of Utility Values for Lung Cancer

Abstract: Methodological factors significantly affect lung cancer utilities; therefore, analysts should avoid direct comparisons of lung cancer utility values elicited with dissimilar methods.

Cited by 68 publications

References 57 publications

A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions

A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions

Understanding Cost-Effectiveness Analyses: An Explanation Using Three Different Analyses of Lung Cancer Screening

Quality of Life and Healthcare Use in a Randomized Controlled Lung Cancer Screening Study

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