title: [Economic impact of lung cancer screening in France: A modeling study].
abstract: BACKGROUND
  The National Lung Screening Trial found that, in a selected population with a high risk of lung cancer, an annual low-dose CT-scan decreased lung cancer mortality by 20% and overall mortality by 7% compared to annual chest X-Ray. In France, a work group stated that individual screening should be considered in this setting. However, the economic impact of an organized and generalized (to all eligible individuals) screening in France was never reported.
  
  
  METHODS
  This is a modeling study using French population demographic data and published data from randomized screening trials. We used the same selection criteria as NLST: 55-74-year-old smokers for at least 30 pack-years, current smoker or quit less than 15 years. We computed a second model including also 50-54-year-old individuals. Then, we used different participation rates: 65%, 45%, and 32%.
  
  
  RESULTS
  According to the considered model, there would be 1,650,588 to 2,283,993 subjects eligible to screening in France. According to the model and participation rate, lung cancer screening would diagnose 3600 to 10,118 stages 1/2 lung cancer each year. There would be 5991 to 16,839 false-positives, of whom 1416 to 3981 would undergo unnecessary surgery. Screening policy would cost 105 to 215 € million per year. However, increasing the price of a cigarette pack by 0.05 to 0.10 € would fully cover the screening costs.
  
  
  CONCLUSIONS
  Participation rate is a key point for screening impact. Screening could be easily funded by a small increase in cigarette prices.
authors.affiliation: Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut du cancer, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France.
authors.forename: S
authors.initials: S
authors.lastname: Gendarme
authors.affiliation: Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut du cancer, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France.
authors.forename: É
authors.initials: É
authors.lastname: Perrot
authors.affiliation: Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut du cancer, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France.
authors.forename: F
authors.initials: F
authors.lastname: Reskot
authors.affiliation: Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut du cancer, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France.
authors.forename: V
authors.initials: V
authors.lastname: Bhoowabul
authors.affiliation: Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut du cancer, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France.
authors.forename: G
authors.initials: G
authors.lastname: Fourre
authors.affiliation: Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut du cancer, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France; EMR 3738 ciblage thérapeutique en oncologie, faculté de médecine et de maïeutique Lyon Sud - Charles-Mérieux, université Claude-Bernard - Lyon 1, 69600 Oullins, France.
authors.forename: P-J
authors.initials: PJ
authors.lastname: Souquet
authors.affiliation: Intergroupe francophone de cancérologie thoracique, 75010 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Milleron
authors.affiliation: Service de pneumologie aiguë spécialisée et cancérologie thoracique, institut du cancer, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France; EMR 3738 ciblage thérapeutique en oncologie, faculté de médecine et de maïeutique Lyon Sud - Charles-Mérieux, université Claude-Bernard - Lyon 1, 69600 Oullins, France. Electronic address: sebastien.couraud@chu-lyon.fr.
authors.forename: S
authors.initials: S
authors.lastname: Couraud
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D018803:Models, Economic; D010358:Patient Participation; D013902:Radiography, Thoracic / Q000191:economics / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000706:statistics & numerical data; D019564:Unnecessary Procedures / Q000191:economics / Q000706:statistics & numerical data
keywords: Cancer du poumon; Cancer screening; Dépistage du cancer; Lung cancer; Modeling; Modélisation; Tabac; Tobacco