Angela C. Tramontano

Cost-Effectiveness of Computed Tomography Screening for Lung Cancer in the United States

Introduction: A randomized trial has demonstrated that lung cancer screening reduces mortality. Identifying participant and program characteristics that influence the cost-effectiveness of screening will help translate trial results into benefits at the population level. Methods: Six U.S. cohorts (men and women aged 50, 60, or 70 years) were simulated in an existing patient-level lung cancer model. Smoking histories reflected observed U.S. patterns. We simulated lifetime histories of 500,000 identical individuals per cohort in each scenario. Costs per quality-adjusted life-year gained (

Original Articles: Diagnostic Tests/StagingCost-Effectiveness of Computed Tomography Screening for Lung Cancer in the United States

/QALY) were estimated for each program: computed tomography screening; stand-alone smoking cessation therapies (4–30% 1-year abstinence); and combined programs. Results: Annual screening of current and former smokers aged 50 to 74 years costs between

Coxibs versus Combination NSAID and PPI Therapy for Chronic Pain: An Exploration of the Risks, Benefits, and Costs

126,000 and

Adopting helical CT screening for lung cancer: potential health consequences during a 15-year period.

169,000/QALY (minimum 20 pack-years of smoking) or

Adopting helical CT screening for lung cancer

110,000 and

Statins and aspirin for chemoprevention in Barrett's esophagus: results of a cost-effectiveness analysis.

166,000/QALY (40 pack-year minimum), when compared with no screening and assuming background quit rates. Screening was beneficial but had a higher cost per QALY when the model included radiation-induced lung cancers. If screen participation doubled background quit rates, the cost of annual screening (at age 50 years, 20 pack-year minimum) was below

Personalizing annual lung cancer screening for patients with chronic obstructive pulmonary disease: A decision analysis

75,000/QALY. If screen participation halved background quit rates, benefits from screening were nearly erased. If screening had no effect on quit rates, annual screening costs more but provided fewer QALYs than annual cessation therapies. Annual combined screening/cessation therapy programs at age 50 years costs

Chapter 9: The MGH-HMS lung cancer policy model: tobacco control versus screening.

130,500 to

The MGH-HMS Lung Cancer Policy Model: Tobacco Control versus Screening

159,700/QALY, when compared with annual stand-alone cessation. Conclusions: The cost-effectiveness of computed tomography screening will likely be strongly linked to achievable smoking cessation rates. Trials and further modeling should explore the consequences of relationships between smoking behaviors and screen participation.

The Impact of a Prior Diagnosis of Barrett’s Esophagus on Esophageal Adenocarcinoma Survival

Introduction: A randomized trial has demonstrated that lung cancer screening reduces mortality. Identifying participant and program characteristics that influence the cost-effectiveness of screening will help translate trial results into benefits at the population level. Methods: Six U.S. cohorts (men and women aged 50, 60, or 70 years) were simulated in an existing patient-level lung cancer model. Smoking histories reflected observed U.S. patterns. We simulated lifetime histories of 500,000 identical individuals per cohort in each scenario. Costs per quality-adjusted life-year gained (