Pcn294 Identifying Non-Small Cell Lung Cancer Patients From a Cohort of Heterogeneous Lung Cancer Patients Using Boosted Trees on Electronic Health Records Data

Abstract

impact of varying adherence rates on the relative benefits of FIT and mt-sDNA screening. Methods: Sensitivity and specificity from DeeP-C trial data were used for screening inputs. Predicted outcomes of annual FIT and triennial mt-sDNA were simulated for individuals born in 1975 who were free of diagnosed CRC at age 40 and screened between ages 50-75. Adherence was set by assuming a fixed annual likelihood to comply ranging from 0-100%, in 10% increments. It was assumed that patients were offered a stool-based screening test yearly unless they were not due for screening. Predicted outcomes are per 1000 individuals versus no screening. Results: Each screening strategy yielded higher life-years gained (LYG) versus no screening. At perfect adherence, mt-sDNA resulted in 4.1% fewer LYG (LYG=302.2; colonoscopies=1856) versus FIT (LYG=315.2; colonoscopies =1915). At imperfect adherence rates of 70% for triennial mt-sDNA and 40% for annual FIT, mt-sDNA resulted in a 19.1% increase in LYG (288.9; colonoscopies=1724) versus FIT (242.5; colonoscopies=1218). LYG for FIT was more sensitive to per-unit change in adherence rates ([315.22101.2]/ [100%210%]=2.4 LYG/unit change) than mt-sDNA (1.8 LYG/unit change). At equivalent adherence, mt-sDNA generally resulted in higher colonoscopies and lower stool testing vs FIT. Conclusions: Stool-based CRC screening provides higher LYG vs no screening, regardless of adherence assumptions. The comparative effectiveness of FIT versus mt-sDNA screening changes dramatically when assuming adherence is ,100%, with mt-sDNA outperforming FIT under adherence assumptions that are more consistent with available, although currently incomplete, real-world evidence.