scholarly journals Benefits and Harms of Computed Tomography Lung Cancer Screening Strategies: A Comparative Modeling Study for the U.S. Preventive Services Task Force

2014 ◽  
Vol 160 (5) ◽  
pp. 311 ◽  
Author(s):  
Harry J. de Koning ◽  
Rafael Meza ◽  
Sylvia K. Plevritis ◽  
Kevin ten Haaf ◽  
Vidit N. Munshi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Screening ◽  
Task Force ◽  
Preventive Services ◽  
Lung Cancer Screening ◽  
Comparative Modeling ◽  
Screening Strategies ◽  
The U.S ◽  
Modeling Study

scholarly journals A Comparative Modeling Analysis of Risk-Based Lung Cancer Screening Strategies

2019 ◽  
Vol 112 (5) ◽  
pp. 466-479 ◽  
Author(s):  
Kevin ten Haaf ◽  
Mehrad Bastani ◽  
Pianpian Cao ◽  
Jihyoun Jeon ◽  
Iakovos Toumazis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Risk Prediction ◽  
Prediction Models ◽  
Lung Cancer Screening ◽  
Comparative Modeling ◽  
Risk Prediction Models ◽  
Life Years ◽  
Screening Strategies

Abstract 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 (<5 years) from screening retains the life-years gained by risk-based screening, while reducing overdiagnosis by more than 65.3%. 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.

The US Preventive Services Task Force Recommendation on Lung Cancer Screening

JAMA ◽  
2021 ◽  
Vol 326 (5) ◽  
pp. 440
Author(s):  
Bryan S. Squires ◽  
Ronald Levitin ◽  
Inga S. Grills
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Task Force ◽  
Preventive Services ◽  
Lung Cancer Screening ◽  
The Us
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