دورية أكاديمية
أعرض في EDS

Selection of eligible participants for screening for lung cancer using primary care data.

التفاصيل البيبلوغرافية
العنوان: Selection of eligible participants for screening for lung cancer using primary care data.
المؤلفون: O'Dowd EL; Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK., Ten Haaf K; Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Kaur J; Department of Epidemiology, University of Nottingham School of Medicine, Nottingham, UK., Duffy SW; Wolfson Institute of Preventive Medicine, Barts and London, London, UK., Hamilton W; Primary Care Diagnostics, University of Exeter, Exeter, UK., Hubbard RB; Department of Epidemiology, University of Nottingham School of Medicine, Nottingham, UK., Field JK; Department of Molecular and Clinical Cancer Medicine, Institute of Systems, University of Liverpool, Liverpool, UK., Callister ME; Department of Respiratory Medicine, Leeds Teaching Hospitals, Leeds, UK., Janes SM; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK., de Koning HJ; Public Health, Erasmus MC, Rotterdam, The Netherlands., Rawlinson J; European Lung Foundation, Birmingham, UK., Baldwin DR; City Campus, Nottingham University Hospitals NHS Trust, Nottingham, UK david.baldwin@nuh.nhs.uk.
المصدر: Thorax [Thorax] 2022 Sep; Vol. 77 (9), pp. 882-890. Date of Electronic Publication: 2021 Oct 29.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: British Medical Assn Country of Publication: England NLM ID: 0417353 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-3296 (Electronic) Linking ISSN: 00406376 NLM ISO Abbreviation: Thorax Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : British Medical Assn.
مواضيع طبية MeSH: Early Detection of Cancer* , Lung Neoplasms*/diagnosis , Lung Neoplasms*/epidemiology, Humans ; Male ; Mass Screening ; Primary Health Care ; Risk Assessment
مستخلص: Lung cancer screening is effective if offered to people at increased risk of the disease. Currently, direct contact with potential participants is required for evaluating risk. A way to reduce the number of ineligible people contacted might be to apply risk-prediction models directly to digital primary care data, but model performance in this setting is unknown.
Method: The Clinical Practice Research Datalink, a computerised, longitudinal primary care database, was used to evaluate the Liverpool Lung Project V.2 (LLP v2 ) and Prostate Lung Colorectal and Ovarian (modified 2012) (PLCO m2012 ) models. Lung cancer occurrence over 5-6 years was measured in ever-smokers aged 50-80 years and compared with 5-year (LLP v2 ) and 6-year (PLCO m2012 ) predicted risk.
Results: Over 5 and 6 years, 7123 and 7876 lung cancers occurred, respectively, from a cohort of 842 109 ever-smokers. After recalibration, LLP V2 produced a c-statistic of 0.700 (0.694-0.710), but mean predicted risk was over-estimated (predicted: 4.61%, actual: 0.9%). PLCO m2012 showed similar performance (c-statistic: 0.679 (0.673-0.685), predicted risk: 3.76%. Applying risk-thresholds of 1% (LLP v2 ) and 0.15% (PLCO m2012 ), would avoid contacting 42.7% and 27.4% of ever-smokers who did not develop lung cancer for screening eligibility assessment, at the cost of missing 15.6% and 11.4% of lung cancers.
Conclusion: Risk-prediction models showed only moderate discrimination when applied to routinely collected primary care data, which may be explained by quality and completeness of data. However, they may substantially reduce the number of people for initial evaluation of screening eligibility, at the cost of missing some lung cancers. Further work is needed to establish whether newer models have improved performance in primary care data.
Competing Interests: Competing interests: KtH reports grants from Cancer Research UK, during the conduct of the study; grants from European Union (Horizon 2020), grants from University of Zurich, Switzerland, non-financial support from International Association for the Study of Lung Cancer, non-financial support from International Association for the Study of Lung Cancer, non-financial support from Russian Society of Clinical Oncology, non-financial support and other from Biomedical Research In Endstage And Obstructive Lung Disease Hannover (BREATH), grants from NIH/National Cancer Institute, outside the submitted work. WH is Co-PI of CanTest Collaborative, funded by Cancer Research UK. RBH reports personal fees from Galapagos, outside the submitted work. SMJ reports grants from GRAIL, personal fees from AstraZeneca, personal fees from BARD1 Bioscience, personal fees from Achilles Therapeutics, grants from Owlstone, other from Optellum, personal fees from Johnson and Johnson, other from AstraZeneca, outside the submitted work. HJdK reports grants from Cancer Research UK, during the conduct of the study; grants from European Union (Horizon 2020), personal fees from University of Zurich, Switzerland / MSD, personal fees from IPSOS London, grants from NIH/National Cancer Institute, personal fees from Teva, Copenhagen, Denmark, outside the submitted work. DRB reports grants from Cancer Research UK, during the conduct of the study; personal fees from Roche, personal fees from AstraZeneca, personal fees from MSD, personal fees from BMS, outside the submitted work.
(© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
معلومات مُعتمدة: 26388 United Kingdom CRUK_ Cancer Research UK; C8640/A23385 United Kingdom CRUK_ Cancer Research UK
فهرسة مساهمة: Keywords: imaging/CT MRI etc; lung cancer
تواريخ الأحداث: Date Created: 20211030 Date Completed: 20220819 Latest Revision: 20221006
رمز التحديث: 20231215
DOI: 10.1136/thoraxjnl-2021-217142
PMID: 34716280
قاعدة البيانات: MEDLINE
الوصف
تدمد:1468-3296
DOI:10.1136/thoraxjnl-2021-217142