Eligibility for low-dose computerized tomography screening among asbestos-exposed individuals

Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects

“…The medical–economic impact of LC screening programs for smokers in the general population, addressed in numerous studies as a function of the risks and healthcare systems, yielded ICERs ranging from 28,000 to 169,000 $/QALY in North America [ 36 , 37 , 38 ], 44,000 $/QALY in New Zealand [ 39 ], and from 35,674 to 69,099 €/QALY in Europe [ 40 ]. Data on persons exposed to asbestos are scarce [ 41 ].…”

“…Evaluation of the degree of occupational exposure is another important eligibility factor. Another analysis based on biennial LDTCT scans of subjects with occupational exposure [ 41 ] found an ICER that ranged from 25,400 to 41,400 $/QALY. According to that analysis, the optimal population would be smokers with >15 pack-years and an occupational exposure-linked relative risk >2 [ 20 ].…”

ACR Appropriateness Criteria® Occupational Lung Diseases

“…Because of this increased risk, evaluation of occupational lung disease requires an increased level of suspicion for malignancy and may warrant the use of advanced imaging. Characteristic CT imaging features may help differentiate occupational lung disease from thoracic neoplasm, with additional CT imaging benefits to include potential for cancer screening, risk stratification, and guidance for biopsy [103][104][105][106][107][108][109][110][111]. As further discussed and supported in the ACR Appropriateness CriteriaÒ topic on "Noninvasive Clinical Staging of Primary Lung Cancer" [112], CT chest with IV contrast is recommended for initial imaging because of improved characterization of direct extrapulmonary tumor invasion and thoracic metastatic disease.…”

Re: Fitzgerald et al. “Eligibility for low-dose computerized tomography screening among asbestos-exposed individuals”

“…We read with particular interest Fitzgerald et al's recent paper that detailed eligibility for lung cancer screening using this method (5). Some observations in France about the related question of asbestos might give further useful insight into complicated questions relevant to lung cancer screening and its financial consequences.…”