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Research Article
16 July 2026

Lung cancer screening in Lithuania: a cost-effectiveness analysis

Authors: Hilde ten Berge [email protected], Greta Piazza, Dianne Ramaker, Xuanqi Pan, Titas Bukšnys, Saulius Cicėnas, Skaidrius Miliauskas, Giedre Smailyte, Rolandas Zablockis, Marius Zemaitis, and Edvardas DanilaAuthor Info & Affiliations
Volume 15, Number 8
https://doi.org/10.57264/cer-2026-0034
PDFFormats

Abstract

Aim: This study aimed to assess the cost-effectiveness of the annual volumetric-enabled low-dose computed tomography (LDCT) lung cancer screening (LCS), based on the NELSON screening outcomes, versus no screening for the asymptomatic high-risk population in Lithuania. Materials & methods: The previously established model with a decision tree with an integrated state-transition Markov trace was adapted to assess the health benefits and the financial consequences of LCS from the Lithuanian healthcare system perspective. Individuals aged 50–74 years and with a smoking history underwent LCS with LDCT in the screening arm, and it was compared with the absence of screening across a lifetime horizon. The primary outcomes included the clinical benefits (lung cancer cases detected per stage and premature lung cancer deaths averted), direct costs (recruitment, diagnostic and treatment costs) of LCS implementation, quality-adjusted life years, life-years and the incremental cost-effectiveness ratio. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to ascertain the result's robustness. Results: Annual LCS with volumetric-enabled LDCT for 170,808 eligible individuals in Lithuania resulted in 6117 additional early-stage (I and II) lung cancers detected and 1874 averted late-stage (III and IV) lung cancers, leading to 2606 premature lung cancer deaths averted and 21,639 life-years gained at an uptake rate of 46.5%. The incremental cost-effectiveness ratio was €1372 per quality-adjusted life year with incremental costs of €21.1 million and 15,391 quality-adjusted life years gained. The results were robust based on sensitivity and scenario analyses. Conclusion: This study demonstrated that annual LCS with volumetric-enabled LDCT for a high-risk population could be cost-effective compared with no screening in Lithuania.

Plain language summary

What is this article about?

Several lung cancer screening (LCS) studies have been carried out worldwide, with the two largest studies showing that screening people at high risk can reduce deaths from lung cancer. In 2024, Lithuania launched a pilot LCS study to assess feasibility, organization and clinical effectiveness in 2024. In evaluating the introduction of a new screening program, cost-effectiveness analysis plays a central role in informing national screening decisions. Therefore, our study assessed both the health benefits and the economic impact of the LCS program in Lithuania by conducting a cost-effectiveness analysis.

What were the results?

The study found that LCS leads to better health outcomes for high-risk individuals. Although screening increases healthcare costs, these additional costs are considered acceptable. Overall, LCS was shown to be cost-effective compared with no screening. The incremental cost-effectiveness ratio was €1372 per quality-adjusted life year gained.

What do the results mean?

These results suggest that implementing LCS in Lithuania could be a better approach for diagnosing lung cancer than the current clinical pathway without screening. The findings provide valuable evidence for policymakers and healthcare decision-makers and support the consideration of launching a LCS program in Lithuania.

Supplementary Material

File (supplementary data.docx)

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