ArticleJournal of medical screening2022
Evaluation of benefits and harms of adaptive screening schedules for lung cancer: A microsimulation study.
Article in Journal of medical screening, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Computed Tomographic Screening Intervals for Patients at Moderate Risk of Lung Cancer.JAMA network open · 2025Article
- Natural history models for lung Cancer: A scoping review.Lung cancer (Amsterdam, Netherlands) · 2025Article
- Benchmarking lung cancer screening programmes with adaptive screening frequency against the optimal screening schedules derived from the ENGAGE framework: a comparative microsimulation study.EClinicalMedicine · 2024Article
- The Impact of Model Assumptions on Personalized Lung Cancer Screening Recommendations.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- Using the Past to Understand the Future of U.S. and Global Smoking Disparities: A Birth Cohort Perspective.American journal of preventive medicine · 2023Article
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Authors and funding
3 authors.
Funding
Abstract
backgroundAlthough lung cancer screening (LCS) has been proven effective in reducing lung cancer mortality, it is associated with some potential harms, such as false positives and invasive follow-up procedures. Determining the time to next screen based on individual risk could reduce harms while maintaining health gains. Here, we evaluate the benefits and harms of LCS strategies with adaptive schedules, and compare these with those from non-adaptive strategies.
methodsWe extended the Lee and Zelen risk threshold method to select screening schedules based on individual's lung cancer risk and life expectancy (adaptive schedules). We compared the health benefits and harms of these adaptive schedules with regular (non-adaptive) schedules (annual, biennial and triennial) using a validated lung cancer microsimulation model. Outcomes include lung cancer deaths (LCD) averted, life years gained (LYG), discounted quality adjusted life years (QALYs) gained, and false positives per LCD averted. We also explored the impact of varying screening-related disutilities.
resultsIn comparison to standard regular screening recommendations, risk-dependent adaptive screening reduced screening harms while maintaining a similar level of health benefits. The net gains and the balance of benefits and harms from LCS with efficient adaptive schedules were improved compared to those from regular screening, especially when the screening-related disutilities are high.
conclusionsAdaptive screening schedules can reduce the associated harms of screening while maintaining its associated lung cancer mortality reductions and years of life gained. Our study identifies individually tailored schedules that optimize the screening benefit/harm trade-offs.
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