ArticleJournal of the National Cancer Institute2020
A Comparative Modeling Analysis of Risk-Based Lung Cancer Screening Strategies.
Article in Journal of the National Cancer Institute, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 5 of them syntheses that pooled it.
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68 citing papers in PubMed, 5 syntheses or guidelines pooled it, 107 citations in OpenAlex.
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- Risk prediction models for esophageal cancer: A systematic review and critical appraisal.Cancer medicine · 2021Pooled it
- Benefits and harms of lung cancer screening strategies in Argentina: a modeling study.Lancet regional health. Americas · 2026Article
- Improving lung cancer screening diagnostic efficiency.Current opinion in pulmonary medicine · 2026Review
- Performance of smoking duration-based lung cancer screening eligibility criteria: a comparative modeling study.Journal of the National Cancer Institute · 2026Article
- Impact of lung cancer screening eligibility criteria on participants' characteristics and healthcare resources.International journal of cancer · 2026Article
- Considering research waste in economic evaluations of low-dose computed tomography screening for lung cancer.International journal of technology assessment in health care · 2026Review
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- A hybrid LSTM-GRU framework for lung cancer classification using GWO-WOA algorithm for hyperparameter tuning and BPSO for feature selection.Scientific reports · 2026Article
- Eligibility and Prognostic Performance of Smoking Duration-Based Versus Pack-Year-Based U.S. National Lung Cancer Screening Criteria Across Racial and Ethnic Groups.Annals of internal medicine · 2026Article
- Article
- Updates in Lung Cancer Screening: A Decade of Evidence.Seminars in respiratory and critical care medicine · 2025Review
- Assessment and recalibration of seventeen lung cancer risk prediction models in approximately one million Chinese population utilising healthcare big data: a retrospective cohort analysis.The Lancet regional health. Western Pacific · 2025Article
- Natural history models for lung Cancer: A scoping review.Lung cancer (Amsterdam, Netherlands) · 2025Article
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- Identifying lung cancer in Emergency Department patients outside national lung cancer screening guidelines.Journal of thoracic disease · 2025Article
- Occult metastases and survival of lung cancer by clinical diagnosis and CT screening: A simulation study.PloS one · 2025Article
8 more citing papers are in PubMed but not listed here.
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13 authors at 6 institutions in 3 countries.
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Abstract
backgroundRisk-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.
methodsFour 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.
resultsRisk-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%.
conclusionsRisk-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.
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