Cost-Benefit Analysis of Chest X-ray Screening in Specific Populations

Yun-Tsan Liao, Jen-Hao Cheng, Chien-Ban Hsu, Yen-Fang Huang, Chang-Hsun Chen

2015 Vol.31 NO.6

Correspondence Author: Yun-Tsan Liao

  • Division of HIV/AIDS and TB, Centers for Disease Control, Ministry of Health and Welfare, Taiwan


The target populations of Taiwan CDC chest X-ray (CXR) screening program varied over the past decade. In this article, costs and benefits of CXR screening on these populations were analyzed, including people in mountainous districts and economically disadvantaged people.

Cost-benefit analysis of CXR screening was done by comparison of screening list from local health bureaus during 2011-2012 to list of nationwide tuberculosis (TB) cases detected in 2012 by active case finding in mountainous districts and economically disadvantaged people, respectively.

TB case detection rates were similar in both years among mountainous people and not related to CXR examination in previous year, both exceeded 4-times than the national  rate (previous examination status unknown, 289.4/100,000; previously unexamined, 230.8/100,000; and previously examined, 248.6/100,000). TB detection rate from CXR screening in disadvantaged people during 2010-2012 was 2X higher than national average (91.0/100,000 in 2010; 205.7/100,000 in 2011 and 113.2/100,000 in 2012).

CXR screening strategy was proven to be very successful and cost-effective in active case finding among either mountainous or economically disadvantaged people, and should be continuously endorsed by Taiwan CDC to reduce the burden of TB in these high-risk populations.

Keywords:tuberculosis;chest X-ray screening;target population;mountainous district;economically disadvantaged people