Background This study evaluates the economic implications of incorporating a CIZ1B biomarker blood test into lung cancer screening protocols for Medicare-eligible high-risk populations. Despite the proven mortality reduction benefits of low-dose computed tomography (LDCT), its adoption remains low. Barriers such as access disparities, logistical challenges, and the high rate of false positives necessitating invasive follow-up limit LDCT’s broader acceptance. The addition of a blood-based biomarker test like CIZ1B could address these barriers by enhancing screening precision, reducing unnecessary diagnostic procedures, and increasing screening participation.

Methods An economic model was developed to assess the cost savings and public health benefits of integrating CIZ1B in three scenarios: (1) sequential screening with LDCT following a positive biomarker test; (2) using CIZ1B to confirm LDCT-positive cases; and (3) an expanded screening paradigm where CIZ1B reduces barriers, increasing overall screening uptake. The model incorporates Medicare reimbursement rates, prevalence and screening sensitivity data, and cost estimates adjusted for inflation.

Results Results indicate that integrating CIZ1B testing can yield net savings in the range of $500 Million by avoiding unnecessary biopsies and enabling earlier lung cancer detection and treatment. The expanded screening scenario projects additional savings through higher participation rates. This study highlights the potential of the CIZ1B biomarker to address critical challenges in lung cancer screening, reduce healthcare costs, and improve outcomes for high-risk populations.

All authors are employees or contractors of Sigla Sciences and Sigla Sciences received financial support from Cizzle Bio for the submitted work.

This study was funded by Cizzle Bio.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors