Cost-Effectiveness of Lung Cancer Screening Strategies For All Populations

ABSTRACT Low-dose computed tomography (LDCT) screening reduces lung cancer mortality. However, screening rates remain low in the United States. Existing lung cancer screening guidelines—such as those issued by the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS)—base eligibility primarily on age and smoking history. Alternative strategies, such as risk prediction models (e.g., PLCOm2012), incorporate additional clinical risk factors and may improve the identification of individuals at elevated risk for lung cancer. This project will evaluate the cost-effectiveness and population health outcomes of three real-world screening strategies: USPSTF guidelines, ACS guidelines, and the PLCOm2012 model-based approach. The study will use an enhanced cost-effectiveness framework to assess how each strategy performs across clinically relevant subgroups, including variations in age, smoking history, and other health indicators. Aim 1 will compare the relative cost-effectiveness of each strategy under real-world implementation conditions. Aim 2 will examine trade-offs between maximizing population-level benefits and optimizing resource allocation. Aim 3 will develop a decision-support tool to aid policymakers and healthcare administrators in selecting effective screening approaches across different population segments. This project will inform the development of practical, evidence-based screening policies to improve lung cancer detection and outcomes in the U.S. adult population.