Background: Diagnostic blood tests have the potential to identify lung cancer in people
at high risk. We assessed the cost-effectiveness of a lung cancer screening intervention, using the
EarlyCDT®-Lung Test (ECLS) with subsequent X-ray and low-dose chest CT scans (LDCT) for
patients with a positive test result, compared to both usual care and LDCT screening for the target
population. Methods: We conducted a model-based lifetime analysis from a UK NHS and personal
social services perspective. We estimated incremental net monetary benefit (NMB) for the ECLS
intervention compared to no screening and to LDCT screening. Results: The incremental NMB of
ECLS intervention compared to no screening was GBP 33,179 (95% CI: −GBP 81,396, GBP 147,180)
and GBP 140,609 (95% CI: −GBP 36,255, GBP 316,612), respectively, for a cost-effectiveness threshold
of GBP 20,000 and GBP 30,000 per quality-adjusted life year. The same figures compared with LDCT
screening were GBP 162,095 (95% CI: GBP 52,698, GBP 271,735) and GBP 52,185 (95% CI: −GBP
115,152, GBP 219,711). Conclusions: The ECLS intervention is the most cost-effective screening
alternative, with the highest probability of being cost-effective, when compared to no screening or
LDCT screening. This result may change with modifications of the parameters, suggesting that the
three alternatives considered in the main analysis are potentially cost-effective.
