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| Comparison of the cost-effectiveness of the lung CT and common chest radiographs in the screening of the patients in the physical examination |
| LU Feng ZHENG Yansong |
| Healthy Management Institute, Chinese PLA General Hospital, Beijing 100853, China |
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Abstract Objective To evaluate the clinical value and health economics of chest X-ray and chest CT scan in health examination people. Methods The results of chest X-ray and chest CT scan in patients who received health examinations in Healthy Science Center of Chinese PLA General Hospital from October 2005 to February 2014 were analyzed. Results A total of 65 465 patients underwent chest X-ray examination, 10 874 patients had positive findings (positive rate was 16.61%), the total positive findings were 12 991 cases. A total of 46 406 patients underwent chest CT scanning, 21 583 patients had positive findings (positive rate was 46.51%), the total positive findings were 33 172 cases. Chest CT scanning was more effective in detecting the lesions compared with chest X-ray (46.51% vs. 16.61%, P < 0.05). In every different age group, chest CT showed higher positive findings rate than chest X-ray examination, the most obvious differences were in 40-＜50 years group (42.42% vs. 12.29%) and 50-＜60 years group (53.44% vs. 22.87%). Chest CT scan detected more lung lesions (16 072 cases vs. 3335 cases), more mediastinal lesions (276 cases vs. 98 cases), pleural lesions (6692 cases vs. 3148 cases), lymph node lesions (3172 cases vs. 190 cases) and abdominal diseases (3172 cases vs. 26 cases) than chest X-ray examination. Chest X-ray examination detected more spinal and thoracic lesions (2798 cases vs. 129 cases), heart and vascular diseases (3095 cases vs. 1837 cases) than chest CT (P < 0.05). The cost of chest CT scan for every single positive reporting was less than chest X-ray (433.67 yuan vs. 554.32 yuan). Conclusion For health examination, chest CT scan is more effective and more economic than chest X-ray examination.
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