title: Cost-effectiveness of positron emission tomography for non-small cell lung carcinoma in Canada.
abstract: BACKGROUND
  Several studies over the past decade have demonstrated that 2-fluoro-2-D-[18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) is more accurate than computed tomography (CT) for the staging of non-small cell lung carcinoma (NSCLC). This study uses quantitative decision tree modeling and sensitivity analysis to assess the cost-effectiveness of both a CT- and a CT+PET-based management strategy for staging NSCLC in Canada. Both management costs and life expectancy are determined.
  
  
  METHODS
  Two patient management scenarios were compared--one using CT alone and one using both CT and PET. A survey of recent literature was used to construct a meta-analysis of available studies for the accuracies of CT and PET in staging NSCLC. Life expectancies were determined from recent Canadian statistics, and expected life expectancies with disease were calculated from knowledge of published survival rates. Management costs were determined from: estimates of the installation cost of PET facilities in Canada; management costs from our institutions; and recently published Canadian cost estimates of various procedures.
  
  
  RESULTS
  A cost savings of 1455 Canadian dollars per person is expected for the CT+PET strategy, along with an increase in life expectancy (3.1 days), when compared with the CT alone strategy. This cost savings remained in favour of the CT+PET strategy when subjected to a rigorous sensitivity analysis.
  
  
  CONCLUSIONS
  PET may be a cost effective means of staging NSCLC in Canada.
authors.affiliation: Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada. p97jss@mun.ca
authors.forename: J Scott
authors.initials: JS
authors.lastname: Sloka
authors.forename: Peter Darroch
authors.initials: PD
authors.lastname: Hollett
authors.forename: Maria
authors.initials: M
authors.lastname: Mathews
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D003663:Decision Trees; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D009367:Neoplasm Staging / Q000379:methods*; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed / Q000191:economics*