OBJECTIVES:  Lung cancer is the leading cause of death worldwide. Patients with lung cancer were often diagnosed at late stage. If patients can be diagnosed and treated earlier, the survival rate is above 60%. One large trial by the National Lung Screening Trial (NLST) in the United States found that compared to chest X-ray, low-dose computed tomography (LDCT) screening can reduce 20% death due to lung cancer. However, there were lack of localized clinical or economical evidences regarding the implementation of population-based LDCT lung cancer screening among high-risk smoking groups, in particular for those countries without trial-based evidences. This study used Taiwanese epidemiological local data to conduct an economic evaluation of implementing LDCT screening among high-risk groups. METHODS:  This study conducted 1^st order Markov simulation models to analyze the life-time cost-effectiveness of LDCT screening. Quality-adjusted life years (QALYs) and costs were calculated among high-risk groups between screening and no screening population. Through literature review, database analysis and expert opinions, base parameters were generated.