Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.
To the Editor: Dr Mahadevia and colleagues1 concluded that, even if efficacy of screening with
helical CT were ultimately to be established by ongoing trials, it is unlikely
to be highly cost-effective without significant reductions in costs as well
as in rates of mortality, adherence, and overdiagnosis. The authors incorporated
an exceedingly large number of factors in their analytic model, including
estimates and sensitivity tests of adherence rates to screening protocol;
length, lead time, and overdiagnosis biases; quality of life; and informal
caregiver costs. Yet, given the current state of knowledge, it is precisely
this all-encompassing approach that is worrisome, and one that might lead
prematurely to the conclusion that lung cancer screening with CT is cost-ineffective.
Chirikos TN, Hazelton T, Tockman M, Clark R. Cost-effectiveness of Screening for Lung CancerCost-effectiveness of Screening for Lung Cancer. JAMA. 2003;289(18):2357. doi:10.1001/jama.289.18.2357-a