Cost-effectiveness of one-off upper abdominal CT screening as an add-on to lung cancer screening in England

Sep 23, 2026

Uploaded by Adam

Low-dose CT lung cancer screening is available for high-risk individuals in England, and adding upper abdominal screening could detect additional diseases. The study estimates the cost-effectiveness of one-off upper abdominal CT as an add-on to lung cancer screening, using data from the Yorkshire Kidney Screening Trial feasibility study. A multi-disease health economic model assessed ten cancers and abdominal aortic aneurysm over a lifetime. Probabilistic results estimate £12,085 per QALY, with uncertainty driven by prevalence and severity assumptions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background

Methods

Results

Conclusions

Introduction

Clinical trial registration

British Journal of Cancer [www.nature.com/bjc](www.nature.com/bjc) ARTICLE OPEN Epidemiology Cost-effectiveness of one-off upper abdominal CT screening asan add-on to lung cancer screening in England Chloe Thomas 1 ✉, Laura Heathcote 1, Yuxiao Sun 1,2, Matthew E. J. Callister 3,4, Jessica Kitt5, Sabrina H. Rossi5,6, Bethany Shinkins 3,7, Juliet A. Usher-Smith 6,8, Sophie Whyte 1 and Grant D. Stewart 5,6 on behalf of the YKST Study Group* © The Author(s) 2025 | | BACKGROUND: Low-dose computed tomography (CT) screening for lung cancer is available for high-risk individuals in England. Screening simultaneously for upper abdominal conditions, including cancer, is feasible. Here, we estimate the cost-effectiveness of one-off upper abdominal CT screening, added onto lung cancer screening, based on the Yorkshire Kidney Screening Trial (YKST) feasibility study.
METHODS: A multi-disease health economic model was developed. Ten cancers and abdominal aortic aneurysm (AAA) were modelled over a lifetime horizon. YKST data informed disease prevalence, resource use and screening costs. Costs, quality-adjusted life-years (QALYs) and cost-effectiveness were estimated probabilistically.
RESULTS: Screening per person costs £70.89, produces 0.0059 QALYs, and has 96% probability of being cost-effective, with an incremental cost-effectiveness ratio of £12,085 . AAA contributes most to cost-effectiveness, followed by kidney cancer, but some cancer ﬁndings reduce cost-effectiveness. Screening is more cost-effective at younger ages. Screen-detectable disease prevalence, severity and mortality risk contribute most to uncertainty.
CONCLUSIONS: One-off upper abdominal CT screening is potentially cost-effective, but costs, harms and beneﬁts vary between conditions. Cost-effectiveness is driven by early diagnosis of AAA, then kidney cancer, illustrating the importance of considering all relevant diseases in screening models A larger trial would provide more robust data to reﬁne the cost-effectiveness argument | | | --- | --- | --- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | . .
CLINICAL TRIAL REGISTRATION: [ClinicalTrials.gov:](ClinicalTrials.gov:) NCT05005195 | | | | | British Journal of Cancer (2025) 133:239–247; [https://doi.org/10.1038/s41416-025-03043-z](https://doi.org/10.1038/s41416-025-03043-z) | | | | | | INTRODUCTION Targeted screening aimed at high-risk people is an alternative to population-wide screening that is gaining popularity due to its favourable risk-beneﬁt proﬁle. One such programme is the English National Health Service (NHS) lung cancer screening programme, which is currently being rolled out to people with high lung cancer risk as assessed by the Prostate, Lung, Colorectal and Ovarian cancer screening trial risk model or the Liverpool Lung Project risk model, via a biennial low-dose thoracic computer tomography (CT) scan [1] . High lung cancer risk is most commonly associated with smoking history, with ever-smokers also at higher risk for a wide range of other conditions, including other cancers, cardiovascular disease and abdominal aortic aneurysm (AAA) [2], many of which may beneﬁt from early detection. For example, people eligible for lung cancer screening are estimated to have 1.6 fold higher risk of kidney cancer than the general population [3], and ever-smokers are estimated to have a 3.28 fold higher risk of AAA than never-smokers [4] . Attendance for a thoracic CT scan could therefore potentially offer a cost- and time-efﬁcient opportunity to screen for other diseases simultaneously, reducing the need for separate screening programmes. The Yorkshire Kidney Screening Trial (YKST) aimed to explore the feasibility and potential clinical beneﬁt of offering an upper abdominal non-contrast CT screen [5], as an add-on to a thoracic CT screen within a community-based trial of lung cancer

FAQs

What was the purpose of adding one-off upper abdominal CT to lung cancer screening?

To assess whether upper abdominal screening for additional conditions can provide favourable cost-effectiveness when offered alongside existing lung cancer CT screening in England.

How was cost-effectiveness evaluated in the study?

A multi-disease health economic model estimated lifetime costs and quality-adjusted life-years (QALYs) for ten cancers and abdominal aortic aneurysm, using Yorkshire Kidney Screening Trial data and probabilistic uncertainty analysis.

Which conditions most influenced cost-effectiveness?

Abdominal aortic aneurysm contributed most, followed by kidney cancer, while some cancer findings reduced cost-effectiveness.

Sep 23, 2026

Uploaded by Adam