Rosell, AntoniBaeza, SoniaMouriño, RocíoSaigí, MariaMunné, MartaLópez de Castro, PedroBechini, JordiEstrada Cuxart, OriolAra del Rey, JordiRicou Ríos, LauraLópez Seguí, Francesc, 1991-2025-10-242025-10-242025Rosell A, Baeza S, Mouriño R, Saigí M, Munné M, López de Castro P, Bechini J, Estrada O, Ara J, Ricou L, López-Seguí F. A cost minimization analysis of the implementation of the international lung screening trial in Catalonia (Spain). BMC Health Serv Res. 2025;25:1001. DOI: 10.1186/s12913-025-13008-w1472-6963http://hdl.handle.net/10230/71651Background NLST and NELSON trial showed that lung cancer mortality can be reduced by 20-24% using low-dose computed tomography screening, due to an increase in early-stage diagnoses. Research question How much lung cancer-related direct costs may be reduced using low-dose computed tomography screening based on the ILST-protocol in a public healthcare system? Methods Cost analysis of lung cancer screening vs. usual care in the framework of the retail price of the Catalan public healthcare system. The lung cancer screening group included costs of screening (ILST-protocol), treatment cost according to weighted average distribution of TNM staging in the NLST and NELSON trials, lung cancer detection rate and smoking-cessation intervention. The usual care group included treatment costs based on distribution of TNM staging registered in the Spanish index hospital. Results In the usual care group, treatment costs were €91,959. In 5-year of lung cancer screening program, the average expected costs per subject were €1,342 (range €1,054-1,832) for screening and €32,431 for treatment, with an expected reduction of €952 based on an average cancer detection rate of 1.6%. The decrease in cost resulting from the stage shift offsets 70.6% of the costs of the screening program. Conclusions The decrease in direct costs associated with lung cancer treatment due to a stage shift resulting from LCS of high-risk populations compensates for a substantial part of the LCS program costs.application/pdfeng© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.info:eu-repo/semantics/article2025-10-24http://dx.doi.org/10.1186/s12913-025-13008-wCost analysisEarly stageHealth economicsLung cancerScreening programinfo:eu-repo/semantics/openAccess