Australia’s newest screening program starts in July next year. See how the researchers say it adds up – both in lives and money saved.
A national lung cancer screening program makes economic sense as well as significantly reducing lung cancer deaths, especially for people at high risk, Australian and Netherlands researchers have found.
The study by Flinders University, working with colleagues in The Netherlands, published in The Lancet Regional Health – Western Pacific this month, provides strong economic evidence to show that a national screening program could be an effective and affordable initiative.
A national risk-based lung cancer program is due to be rolled out in Australia from July 2025.
“Our research shows that screening high-risk individuals every two years would be a cost-effective approach with significant health benefits,” said lead author and health economics researcher Dr Jackie Roseleur, from Flinders’ College of Medicine and Public Health.
“We found that screening people who currently smoke or have quit in the past 10 years and who have a history of heavy smoking (that is, at least a pack of cigarettes a day for 30 years) would cost a little over $60,000 for each additional healthy year of life gained when compared to not screening at all.
“In other words, for every $60,000 spent on screening, one person would gain an extra year of good health.”
These results led to the Medical Services Advisory Committee (MSAC) concluding that the screening program was a worthwhile investment and to recommend the implementation of a national lung cancer screening program in Australia.
Federal health minister Mark Butler approved the recommendation and announced the new screening program in May 2023. It is the first new national cancer screening program in Australia in some 20 years and will target high-risk individuals.
The plan is to screen individuals aged between 50 and 70 years every two years.
Australians will be eligible for the program if they show no signs or symptoms of lung cancer and have a history of at least 30 pack-years of cigarette smoking and are still smoking; or have a history of at least 30 pack-years of cigarette smoking and quit in the past 10 years.
The Lancet study used Australia-specific data on smoking behaviour, lung cancer epidemiology and costs for diagnosing and treating lung cancer, to adapt the MIcrosimulation SCreening ANalysis (MISCAN)-Lung model and create scenarios for screening.
The MISCAN-Lung model, developed by Assistant Professor Kevin ten Haaf in The Netherlands, is a microsimulation model that simulates the life history of individuals to evaluate the benefits, harms and cost-effectiveness of a targeted national lung screening program in Australia.
The researchers found the benefit of this screening was significant and predicted it would prevent 62 lung cancer deaths for every 100,000 people screened and add an average of 8.4 extra healthy years of life for each lung cancer death prevented.
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Flinders University health economist and study co-author Professor Jonathan Karnon said the importance of early detection was paramount.
“Lung cancer prognosis largely depends on how early it is caught. This screening program will allow us to diagnose and treat patients sooner, significantly improving their chances of survival,” he said.
“More than 8500 Australians die every year from lung cancer and that need not continue.
“As Australia moves forward with plans for national lung cancer screening, this study represents a significant step in ensuring that public health strategies are both effective and economically viable.”
This study was the first to comprehensively evaluate the costs and effects of novel therapies in a national lung cancer screening program using natural-history modelling.
