Trends in the Proportion of Patients With Lung Cancer Meeting Screening Criteria

Wang, Yi; Midthun, David E.; Wampfler, Jason A.; Deng, Bo; Stoddard, Shawn M.; Zhang, Shuo; Yang, Ping

doi:10.1001/jama.2015.413

Cited by 55 publications

(55 citation statements)

References 5 publications

(7 reference statements)

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“…7 However, our recent report showed that approximately two thirds of newly diagnosed lung cancer patients would not have met the current USPSTF high-risk criteria for LDCT screening. 8 Particularly, we found a 24% fall-off in meeting screening-eligibility criteria (from 57% in 1984-1990 to 43% in 2005-2011) which exceeded the 17% decline in incidence of lung cancer (from 53 to 44/100,000) over the same time intervals. Herein we have conducted further investigations to delineate the high-risk subpopulations based on evidence from two prospective lung cancer patient cohorts and a retrospective community cohort.…”

Section: Indroductionmentioning

confidence: 56%

Trends in Subpopulations at High Risk for Lung Cancer

Yang

Wang

Wampfler

et al. 2016

Journal of Thoracic Oncology

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Introduction Two thirds of newly diagnosed lung cancer patients in the U.S. would not meet the current USPSTF (United States Preventive Services Task Force) screening criteria, suggesting a need for amendment to the high-risk definition. To provide evidence of additional high-risk subpopulations and estimated gains and losses, we conducted a two-step study using three cohorts. Methods Two prospective cohorts are comprised of 5988 primary lung cancer patients diagnosed between 1997-2011 (Hospital) and 850 defined-community residents (Community); the retrospective cohort is the Olmsted County population (Minnesota, USA) followed for 28 years (1984-2011). Subgroups of lung cancer patients who might have been identified using additional determinates were estimated and compared between Community and Hospital cohorts. Findings were supported by indirect comparative projections of two ratios: benefit to harm and cost to effectiveness. Results Former cigarette smokers with 30 or more pack-years and 15-30 quit-years age 55-80 formed the largest subgroup not meeting the current screening criteria, constituting 12% of the hospital cohort and 17% of community cohort. Using the expanded criteria suggested by our study may add 19% more CT examinations for detecting 16% more cases when comparing to the USPSTF criteria. Meanwhile, the increases of false positive, over-diagnosed and radiation-related lung cancer death are 0.6%, 0.1%, and 4.0%, respectively. Conclusions Current USPSTF screening criteria exclude many patients at high risk for lung cancer. Individuals who are under 81 years, had 30 or more pack-year smoking history, and had quit for 15-30 years may significantly increase the number of non-over diagnosis screen-detected lung cancers, does not significantly add false positive cases, saves more lives, yet with an acceptable amount of elevated scan exposure and cost.

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Section: Indroductionmentioning

confidence: 56%

Trends in Subpopulations at High Risk for Lung Cancer

Yang

Wang

Wampfler

et al. 2016

Journal of Thoracic Oncology

Self Cite

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show abstract

“…Additional diagnostic tests and unnecessary invasive procedures to determine the nature of over-abundant lung nodules would result in potentially increased mortality, morbidity, and healthcare costs. In addition the currently recommended definition for the high-risk individuals to be offered lung cancer screening only includes a subgroup of individuals who will ultimately develop lung cancer [9]. Therefore, there is an urgent need to identify specific, cost-effective non-invasive biomarkers for lung cancer screening.…”

Section: Introductionmentioning

confidence: 99%

Selection of Sensitive Methylation Markers for the Detection of Non-small Cell Lung Cancer

Zhao¹,

Jen²,

Peikert³

2015

J Mol Biomark Diagn

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“…However, there is evidence that these entry criteria might not be sensitive enough in detecting lung cancer cases, considering that in some representative lung cancer cohorts, about half of subjects participating in the trials do not meet NLST criteria [37][38][39] . Furthermore, a recent study has shown a decline over the last 25 years in the proportion of patients meeting the NLST high-risk profile, suggesting that more sensitive criteria may need to be identified 40 . Following this premise, other medical societies have included broader criteria than those from the NLST.…”

Section: Chronic Obstructive Pulmonary Disease and Emphysema As Selecmentioning

confidence: 99%

Use of Biomarkers in Chronic Obstructive Pulmonary Disease: Clinical Implications

Moon¹,

Cho²,

Sin³

2018

BRN

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Trends in the Proportion of Patients With Lung Cancer Meeting Screening Criteria

Cited by 55 publications

References 5 publications

Trends in Subpopulations at High Risk for Lung Cancer

Trends in Subpopulations at High Risk for Lung Cancer

Selection of Sensitive Methylation Markers for the Detection of Non-small Cell Lung Cancer

Use of Biomarkers in Chronic Obstructive Pulmonary Disease: Clinical Implications

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