Biennial low-dose computed tomography screening of adult smokers was found to be cost-effective for Māori, who have a disproportionately high lung cancer disease burden. The cost-effectiveness of low-dose computed tomography screening of adults aged 55–74 years, who had a smoking history of ≥30 pack years or had quit within the last 15 years if a former smoker, was estimated using a macrosimulation stage shift model and incidence rates of lung cancer in New Zealand. The estimated gain in QALYs was 0.067 per participant at a cost of NZ$4211. The model estimated an ICER of NZ$65,000 per QALY gained for the overall cohort and NZ$39,000 per QALY gained for Māori. The acceptable threshold based on gross domestic product per capita per QALY gained was NZ$45,000 so lung cancer screening was concluded as unlikely to be cost-effective for the overall cohort and likely to be cost-effective for the Māori cohort.
