Prendecki, Kathryn Ruth;
(2024)
Health Economic Analysis of Low Dose CT Lung Cancer Screening in a UK Setting.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Low dose CT (LDCT) lung cancer screening in a high-risk population has been demonstrated in clinical trials to reduce lung cancer mortality by 20-24%. However, the debate on whether a screening programme for lung cancer could be cost effective is ongoing with few estimates of the cost-benefit for a UK setting. Although, the UK Screening Committee have recommended a lung cancer screening programme in the UK, evidence such a programme is cost effective and the most efficient protocol for delivering such a programme is incomplete. The SUMMIT study is a London based study which aimed to assess the feasibility of implementing LDCT lung cancer screening for a high-risk population in a UK setting. This study adds relevant evidence on multiple aspects of lung cancer screening which can be used to provide UK relevant estimates on which to base a cost effectiveness analysis. The first section of this thesis describes the analysis of SUMMIT and population data to estimate input parameters for an economic model based on the SUMMIT population and explores uncertainty and sub-group differences in estimates to guide sub-group and sensitivity analysis. This section analyses costs of a screening programme, costs of diagnosis and management of screening outcomes, life expectancy and quality of life and probability of specific screening outcomes to inform transition probabilities within a model. The second section of this thesis, describes the development of an economic model to estimate the cost-effectiveness of lung cancer screening. Using the parameter estimates derived in the first section of the thesis, the model estimates the Incremental Cost Effectiveness Ratio (ICER) for annual LDCT screening compared to no screening at £4,541 per QALY. The model suggests LDCT lung cancer screening is cost effective and provides a tool through which optimal screening scenarios can be further explored.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Health Economic Analysis of Low Dose CT Lung Cancer Screening in a UK Setting |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| Keywords: | Lung Cancer, Economic Evaluation, Screening |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10198526 |
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