OBJECTIVES:

Lung cancer is the leading cause of cancer death worldwide. Results from the National Lung Screening Trial (NLST) show that low-dose computed tomography (LDCT) reduces mortality from lung cancer. This study aimed to estimate the budget impact analysis of Taiwan LDCT screening.

METHODS:

We adopt a budget impact model to estimate the financial consequences of adopting LDCT for lung cancer screening based on the NLST criteria. From the healthcare system perspective, we compared the direct medical cost of the scenario with and without LDCT screening for one year. The cost of the new scenario included the cost of screening, the cost of subsequent positive follow-up within one year, and the cost of lung cancer treatment at each stage. Data sourced from hospital medical records and Taiwan Cancer Registry Annual Report. Sensitivity analysis was conducted to test the impact of uncertainty of model inputs.

RESULTS:

The results showed that a total of 788,252 people met the NLST screening criteria under the new scenario with a screening rate of 95%, of which about 215,429 were screened positive and 207,028 were false positive, resulting in 8,402 confirmed lung cancer cases after screening. About 87.12% of the screened lung cancer patients were stage I patients, and their costs (LDCT screening fee + follow-up examination fee + lung cancer treatment fee) were US$383,726,357; while about 9,035 patients who did not meet the screening criteria and their lung cancer cost was US$281,296,885, Therefore, the total cost of eligible and ineligible screening under the new scenario is $665,023,242. In the original scenario (no screening group), 15,285 people were diagnosed with lung cancer; among them 45.45% were diagnosed with stage IV and stage I (39.01%) at a total cost of US$475,894,439.

CONCLUSIONS:

The difference between screening and no screening was US$189,128,803, which was the budget impact.