Estimating the Cost Effectiveness of Lung Cancer Screening with Low-dose Computed Tomography Considering Early Detection Rate in Iran

Lung cancer is the most common and most deadly cancer in most of countries of the world. One of the most significant problems with this cancer is the lack of accurate and specific statistics about the prevalence and mortality rate in Iran. Results of cancer registry program in 2008 in Iran indicated a low incidence rate of lung cancer. However, these statistics were wrong and far from the reality. Several other studies have been done in Iran demonstrating high incidence rates of lung cancer. On the recent recommendation of international organizations such as, the American Cancer Society (ACS), the American College of Radiology ACR, and the International Association for the Study of Lung Cancer IASLC in 2013, the most effective method for the prevention of mortality due to lung cancer is the annual screening of high risk people with low dose computed tomography (LDCT). The cost effectiveness of this program should be evaluated before the implementation of it in the country.
Methods and Materials: The most important benefit of implementing screening is the increase of lung cancers early detection rate. This is the main basis for calculating the cost effectiveness in different countries. The cost effectiveness of the project has been estimated by using the data in the country and basing on the results of an important project carried out in America and Netherlands (the international NLST project in America and the international NELSON project in Netherland). In addition, the early detection rate was estimated and compared with others.
Our analysis indicates that the implementation of screening will increase the early detection rate about 500% in the country. However, the early detection rate has been increased about 200% in NLST project. Thus, it is estimated that the implementation of this program will have more efficiency in Iran than American and European countries.
Discussion and Lung cancer is one of the most common cancers in Iran; moreover, screening this cancer can rescue the thousands lives of our compatriots annually. Unfortunately, there are no plans to implement and enforce the screening in the country. It seems a incorrect statistics announced by the national cancer registry center in 2008 that showed the low incidence rate of this cancer is the basis for relevant authorities’ decision making. High cigarette consumption, air pollution in metropolis, and the mean age of the elderly are all the alarm for raising this cancer in the country. Screening the lung cancer with low dose CT imaging is considered as the most effective way to control and prevent deaths from this cancer in the country, so it should be paid serious attention by the relevant authorities.