Lung cancer screening strategies based on personal risk are more cost effective than the 2021 US Preventive Services Task Force (USPSTF) recommendations, according to a study published in Annals of Internal Medicine. Iakovos Toumazis, PhD, and colleagues compared the cost-effectiveness of risk model-based lung cancer screening strategies versus the USPSTF recommendation. The risk model-based strategy started screening at age 50 or 55 and stopped screening at 80, with 6-year risk thresholds of 0.5% to 2.2% based on the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial modified 2012 model. The risk model-based screening strategies were more cost-effective than the USPSTF recommendation and comprised the cost-effectiveness efficacy frontier. Strategies with a 6-year risk threshold of 1.2% or greater were cost-effective, with an incremental cost-effectiveness ratio (ICER) of less than $100,000 per quality-adjusted life year (QALY). The ICER was $94,659 for the strategy with a 1.2% risk thresh-
old, which yielded more QALYs for less cost than the USPSTF recommendation, with a similar level of screening coverage (21.7% for the risk model-based strategy vs 22.6% for the USPSTF recommendation).
