OBJECTIVES: Lung cancer (LC) is the leading cause of cancer-related death in Hungary. Early diagnosis of LC contributes to delivering survival benefits to patients. Low-dose computer tomography (LDCT) is an imaging technology that can be used to identify smaller nodules. This study investigated the cost-effectiveness of introducing LDCT screening in Hungary among individuals aged 50 to 74 years with high-risk for developing LC using inputs based on the HUNCHEST-II clinical trial.

METHODS: We conducted a cost-utility analysis over the time horizon of 30 years to compare annual and biennial screening for LC with LDCT against no organised LDCT screening. The economic evaluation simulated a cohort of current and former smokers aged 50 to 74 years with a smoking exposure of at least 25 pack-years, using data from HUNCHEST-II, a multicentre study to evaluating LDCT screening for the early detection of LC. Complementary data were retrieved from published studies and interviews with local experts.

RESULTS: The introduction of annual screening for LC with LDCT yielded an incremental effectiveness of 0.053 QALYs as well as an increase in costs of 481 167 HUFs over 30 years. The value of the base case ICER (9 143 512 HUF/QALY) of screening for LC with LDCT over no organised screening using LDCT is below the relevant cost-effectiveness threshold. Applying a biennial screening strategy using LDCT yielded less favourable cost-effectiveness results (ICER = 9 908 100 HUF/QALY), although still below the relevant threshold.

CONCLUSIONS: Along with the mature data on its effectiveness, our analysis confirms that LDCT for LC screening in high-risk populations is cost-effective in Hungary. Funding a nationwide lung screening program that uses LDCT is a justified decision in economic terms; biannual biennial screening frequency is more feasible from budgetary and organisational perspectives.