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<p>Artificial intelligence (AI) shows promise in improving the accuracy and efficiency of lung cancer screening, but its economic value remains uncertain. We developed a decision-analytic model combining a decision tree and Markov model to evaluate five screening strategies in South Korea: no screening, chest X-ray (CXR), AI-assisted CXR, low-dose computed tomography (LDCT), and AI-assisted LDCT. We simulated hypothetical cohorts of 10,000 individuals, stratified by age group and smoking status to reflect the Korean population distribution, and projected their lifetime costs and quality-adjusted life years (QALYs). Analyses applied a 4.5% discount rate and a willingness-to-pay (WTP) threshold of $32,409.9 per QALY. AI-assisted CXR produced incremental cost-effectiveness ratio (ICER) of $8679–$10,030 per QALY, demonstrating cost-effectiveness across all age groups. CXR alone was less favorable, and LDCT-based strategies exceeded the willingness-to-pay (WTP) threshold. These findings suggest AI-assisted CXR offers a scalable, economically viable strategy for lung cancer screening, supporting its integration into national programs.</p>

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Cost-effectiveness of chest radiography using artificial intelligence for lung cancer screening in South Korea

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月28日

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  • KyungYi Kim,
  • Jung Hyun Kim,
  • Jaeyong Shin,
  • Man S. Kim,
  • Sang-Hoon Park,
  • Jung Hyun Chang,
  • Chang-Hoon Han,
  • Si Nae Oh

摘要

Artificial intelligence (AI) shows promise in improving the accuracy and efficiency of lung cancer screening, but its economic value remains uncertain. We developed a decision-analytic model combining a decision tree and Markov model to evaluate five screening strategies in South Korea: no screening, chest X-ray (CXR), AI-assisted CXR, low-dose computed tomography (LDCT), and AI-assisted LDCT. We simulated hypothetical cohorts of 10,000 individuals, stratified by age group and smoking status to reflect the Korean population distribution, and projected their lifetime costs and quality-adjusted life years (QALYs). Analyses applied a 4.5% discount rate and a willingness-to-pay (WTP) threshold of $32,409.9 per QALY. AI-assisted CXR produced incremental cost-effectiveness ratio (ICER) of $8679–$10,030 per QALY, demonstrating cost-effectiveness across all age groups. CXR alone was less favorable, and LDCT-based strategies exceeded the willingness-to-pay (WTP) threshold. These findings suggest AI-assisted CXR offers a scalable, economically viable strategy for lung cancer screening, supporting its integration into national programs.