Investing in early detection: the economic case for a national lung cancer screening program

A study by Flinders University, working with colleagues in The Netherlands, has shown that a national lung cancer screening program could significantly reduce lung cancer deaths.

The study, published in The Lancet Regional Health - Western Pacific, provides strong economic evidence to show that a national screening program could be an effective and affordable way to fight this deadly cancer.

Lung cancer is the leading cause of cancer-related deaths worldwide, accounting for the highest mortality rates among both men and women. It is often diagnosed late, when treatment options are limited. However, screening individuals at high risk makes early detection possible, which can dramatically improve the chances of survival.

"Our research shows that screening high-risk individuals every two years would be a cost-effective approach with significant health benefits," says lead author and health economics researcher Dr Jackie Roseleur from the 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 is a worthwhile investment and to recommend the implementation of a national lung cancer screening program in Australia. It was subsequently approved by the Minister for Health and Aged Care and will be rolled out in July 2025.

The 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 recommended scenario is to screen individuals aged between 50 and 70 every two years.

The benefit of this screening is significant, it is predicted to 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.

Professor Jonathan Karnon, a health economist at Flinders University and an author on the study, emphasises the importance of early detection.

"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," says Professor Karnon.

“More than 8,500 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,” he says.

The paper, 'Targeted lung cancer screening in the age of immunotherapies and targeted therapies – an economic evaluation for Australia' by Jacqueline Roseleur, Jonathan Karnon, Harry de Koning, Vivienne Milch, Katrina Anderson, Jacqui Real, Dorothy Keefe and Kevin ten Haaf was published in The Lancet Regional Health - Western Pacific. DOI: 10.1016/j.lanwpc.2024.101241