Cost-effectiveness of one-off upper abdominal CT screening as an add-on to lung cancer screening in England.

Thomas, C.; Heathcote, L.; Sun, Y.; Callister, MEJ.; Kitt, J.; Rossi, SH.; Shinkins, B.; Usher-Smith, JA.; Whyte, S.; Stewart, GD.

Cost-effectiveness of one-off upper abdominal CT screening as an add-on to lung cancer screening in England.

All Authors

Thomas, C.

Heathcote, L.

Sun, Y.

Callister, MEJ.

Kitt, J.

Rossi, SH.

Shinkins, B.

Usher-Smith, JA.

Whyte, S.

Stewart, GD.

LTHT Author

Callister, Matthew

LTHT Department

Cardio-Respiratory
Respiratory Medicine

Publication Date

2025

Item Type

Journal Article

Abstract

BACKGROUND: Low-dose computed tomography (CT) screening for lung cancer is available for high-risk individuals in England. Screening simultaneously for upper abdominal conditions, including cancer, is feasible. Here, we estimate the cost-effectiveness of one-off upper abdominal CT screening, added onto lung cancer screening, based on the Yorkshire Kidney Screening Trial (YKST) feasibility study. METHODS: A multi-disease health economic model was developed. Ten cancers and abdominal aortic aneurysm (AAA) were modelled over a lifetime horizon. YKST data informed disease prevalence, resource use and screening costs. Costs, quality-adjusted life-years (QALYs) and cost-effectiveness were estimated probabilistically. RESULTS: Screening per person costs 70.89, produces 0.0059 QALYs, and has 96% probability of being cost-effective, with an incremental cost-effectiveness ratio of 12,085. AAA contributes most to cost-effectiveness, followed by kidney cancer, but some cancer findings reduce cost-effectiveness. Screening is more cost-effective at younger ages. Screen-detectable disease prevalence, severity and mortality risk contribute most to uncertainty. CONCLUSIONS: One-off upper abdominal CT screening is potentially cost-effective, but costs, harms and benefits vary between conditions. Cost-effectiveness is driven by early diagnosis of AAA, then kidney cancer, illustrating the importance of considering all relevant diseases in screening models. A larger trial would provide more robust data to refine the cost-effectiveness argument. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT05005195.