A Comparative Modeling Analysis of Risk-Based Lung Cancer Screening Strategies
| العنوان: | A Comparative Modeling Analysis of Risk-Based Lung Cancer Screening Strategies |
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| المؤلفون: | Kevin ten Haaf, Jihyoun Jeon, Erik F. Blom, Sylvia K. Plevritis, Iakovos Toumazis, Pianpian Cao, Summer S. Han, Mehrad Bastani, Harry J. de Koning, Chung Yin Kong, Martin C. Tammemägi, Rafael Meza, Eric J. Feuer |
| المساهمون: | Public Health |
| المصدر: | Journal of the National Cancer Institute, 112(5):djz164, 466-479. Oxford University Press J Natl Cancer Inst |
| بيانات النشر: | Oxford University Press, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Cancer Research, medicine.medical_specialty, Lung Neoplasms, MEDLINE, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Overdiagnosis, Lung cancer, Early Detection of Cancer, Aged, Aged, 80 and over, Models, Statistical, business.industry, Smoking, Editorials, Middle Aged, medicine.disease, Natural history, Oncology, 030220 oncology & carcinogenesis, Life expectancy, Female, Risk assessment, business, Birth cohort, Lung cancer screening |
| الوصف: | Background Risk-prediction models have been proposed to select individuals for lung cancer screening. However, their long-term effects are uncertain. This study evaluates long-term benefits and harms of risk-based screening compared with current United States Preventive Services Task Force (USPSTF) recommendations. Methods Four independent natural history models were used to perform a comparative modeling study evaluating long-term benefits and harms of selecting individuals for lung cancer screening through risk-prediction models. In total, 363 risk-based screening strategies varying by screening starting and stopping age, risk-prediction model used for eligibility (Bach, PLCOm2012, or Lung Cancer Death Risk Assessment Tool [LCDRAT]), and risk threshold were evaluated for a 1950 US birth cohort. Among the evaluated outcomes were percentage of individuals ever screened, screens required, lung cancer deaths averted, life-years gained, and overdiagnosis. Results Risk-based screening strategies requiring similar screens among individuals ages 55–80 years as the USPSTF criteria (corresponding risk thresholds: Bach = 2.8%; PLCOm2012 = 1.7%; LCDRAT = 1.7%) averted considerably more lung cancer deaths (Bach = 693; PLCOm2012 = 698; LCDRAT = 696; USPSTF = 613). However, life-years gained were only modestly higher (Bach = 8660; PLCOm2012 = 8862; LCDRAT = 8631; USPSTF = 8590), and risk-based strategies had more overdiagnosed cases (Bach = 149; PLCOm2012 = 147; LCDRAT = 150; USPSTF = 115). Sensitivity analyses suggest excluding individuals with limited life expectancies ( Conclusions Risk-based lung cancer screening strategies prevent considerably more lung cancer deaths than current recommendations do. However, they yield modest additional life-years and increased overdiagnosis because of predominantly selecting older individuals. Efficient implementation of risk-based lung cancer screening requires careful consideration of life expectancy for determining optimal individual stopping ages. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1460-2105 0027-8874 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9e8c27168a7834adb55c0550677f31c6 https://pure.eur.nl/en/publications/f2744e54-23ac-4045-bd06-f3ac4fd8735d |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....9e8c27168a7834adb55c0550677f31c6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14602105 00278874 |
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