ESTRO 2024 - Abstract Book

S2867

Interdisciplinary - Health economics & health services research

ESTRO 2024

diagnostic radiologists and eligible population. We also estimated the stage migration anticipated after the implementation of lung cancer screening.

Material/Methods:

Eligibility criteria for the lung cancer screening LDCT program was based on the United States Preventive Services Task Force recommendations(3) and within the boundaries of data limitations (over the age of 45 with at least a 33 pack- year smoking history). Using data from the World Health Organization’s STEPWISE survey(4) an estimate of the number of people in each Jordanian governorate that fit the inclusion criteria was calculated. The number of radiologists and their distribution in Jordan was obtained through the Jordanian Radiology Society(5). The required number of radiologists per million population (PMP) was obtained through recommendations from the Royal College of Radiologists (at least 80 radiologists PMP)(6). The number of CT scanners available was obtained from the Jordanian Energy & Minerals Commission(7). The mean number of CT scanners PMP in 10 countries/regions that have implemented full national/regional LDCT screening was calculated using data from multiple sources(8)(9), and the lower interval of the 95% confidence interval was assumed to be the minimum number of scanners PMP for a functioning LDCT screening program. The anticipated stage migration of lung cancer after the implementation of lung cancer screening in Jordan was modelled based on the stage migration observed in the NELSON trial. The total number of diagnostic radiologists in Jordan is 453, distributed across the 12 governorates (mean=38; range: 2 − 300), the highest number of diagnostic radiologists is in Amman (N=300, 66.2%), the lowest number is in Jerash (N=2, 0.4%) and Tafiela (N=2, 0.4%). Diagnostic radiologists are working in the private sector (N=146, 32.2%), public sector (N=144, 31.8%), university hospitals (N=24, 5.3%), and non-governmental organizations (N=20, 4.4%). The total diagnostic radiologists PMP in Jordan is 38.40 (governorate range: 6.14 − 63.65), with a mean number of 23.13 per governorate. The highest was found in Amman (63.65 PMP), and the lowest in Mafraq (6.14 PMP), all being less than the recommended 80 PMP. About 2.26% of each governorate's population meets the eligibility criteria for LDCT lung cancer screening per the United States Preventive Services Task Force recommendations. The total number of individuals eligible for screening is 255,338 (mean: 21,278; governorate range: 4,239 − 107,188), the highest in Amman (N=107,188) and the lowest was in Ma’an (N=4,239). The mean number of CT scanners in 8 countries (Poland, Croatia, Italy, Romania, South Korea, The United Kingdom, Taiwan, and The Czech Republic) and 2 regions (British Columbia and Ontario in Canada) with full national/regional LDCT lung cancer screening programs is 21.50 ±6.40 (95% CI), providing a minimum of 15.10 CT scanners PMP for nationwide/regionwide screening program. The available CT scanners in Jordan were 185 (governorate range: 2 − 121), most of which are in Amman (N=121, 65%), the second highest being in Irbid (N=18, 10%), and the lowest in Jerash, Tafiela, and Madaba (N=2 each, 1%). CT scanners PMP in Jordan is 16.37 (range: 6.9 − 25.5), with the highest scanners PMP in Amman (25.5) , and the lowest in Balqa (6.9). While Jerash (7.13), Zarqa (8.04), Irbid (8.59), Madaba (8.93), Mafraq (9.22), Karak (13.34) were also all less than (15.10). The number of patients diagnosed at stage I lung cancer is estimated to increase by 199.6% from 21% to account for 53.3% of all cases diagnosed (Table 1). Stages II, III, and IV diagnoses progressively decreased by 14.6%, 30.0%, and 41.5%, respectively. An overall increase of 18.1% in total lung cancer cases diagnosed is expected. National Lung Screening Trial (NLST) reduction of 20% in lung cancer mortality will result in preventing 89 deaths each year based on the mean lung cancer-caused deaths in Jordan between the years of 2014 and 2019. Results: