Cost effectiveness analysis of radon prevention programmes in Franche-Comte

Background: Radon gas is the second lung carcinogen after smoking. There are measures in homes that can reduce the exposure of the population. We studied cost-effectiveness of anti-radon policies in Franche-Comte, one of the most exposed areas in France. Assessed strategies were targeted screening in at risk areas and mass screening, compared to the absence of screening. Method: A Markov model was used to simulate the effects of screening for radon exposure in a population aged between 30 and 75 over a 30-year period. For each strategy, estimated effectiveness parameters were mean life expectancy, incidence of radon-induced lung cancer and number of related deaths. Considered costs were all direct and consisted of invitation to screening, radon measurement, remediation, and lung cancer diagnosis and treatment. The incremental cost-effectiveness ratios (ICERs) were estimated, corresponding to the cost per life year gained, the cost per avoided case of cancer and the cost per avoided death. A discount rate of 3% was used. Results: Individual life years gained were 8x10(-6) for targeted screening and 2.1x10(-5) for mass screening. The mean annual number of radon-induced lung cancer in Franche-Comte was 71.4 as reference, 71.3 for targeted screening and 70.6 for mass screening. Related deaths were respectively 65.4, 65.3 and 64.7. The costs per life year gained were respectively (sic)295,105 for targeted screening and (sic)987,108 for mass screening compared with no screening. Conclusions: Neither targeted nor mass screenings were cost-effective. The struggle against lung cancer induced by radon should rather concentrate on precautionary measures in new homes.