Evaluating the impact of varied compliance to lung cancer screening recommendations using a microsimulation model.

Background: The US preventive services task force (USPSTF) recently recommended that individuals aged 55-80 with heavy smoking history be annually screened by low-dose computed tomography (LDCT), thereby extending the stopping age from 74 to 80 compared to the national lung screening trial (NLST) en...

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Publicado en:Cancer Causes & Control Vol. 28; no. 9; pp. 947 - 959
Autores principales: Han, Summer, Erdogan, S., Toumazis, Iakovos, Leung, Ann, Plevritis, Sylvia, Han, Summer S, Erdogan, S Ayca, Plevritis, Sylvia K
Formato: research tables/charts Journal Article
Publicado: Springer Nature Sep2017
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Evaluating the impact of varied compliance to lung cancer screening recommendations using a microsimulation model.
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          Han, Summer
          Erdogan, S.
          Toumazis, Iakovos
          Leung, Ann
          Plevritis, Sylvia
          Han, Summer S
          Erdogan, S Ayca
          Plevritis, Sylvia K
        affil: Quantitative Sciences Unit, Stanford Center for Biomedical Research (BMIR), Neurosurgery and Medicine , Stanford University School of Medicine , Stanford USA
      sug:
        subj:
          Models, Theoretical
          Lung Neoplasms
          Patient Compliance
          Smoking
          Aged
          Tomography, X-Ray Computed
          Lung Neoplasms Prevention and Control
          United States
          Female
          Male
          Middle Age
          Health Screening Methods
          Policy Making
          Aged, 80 and Over
          Early Detection of Cancer Methods
          Human
          Aged: 65+ years
          Middle Aged: 45-64 years
          Aged, 80 & over
          Female
          Male
      ab: Background: The US preventive services task force (USPSTF) recently recommended that individuals aged 55-80 with heavy smoking history be annually screened by low-dose computed tomography (LDCT), thereby extending the stopping age from 74 to 80 compared to the national lung screening trial (NLST) entry criterion. This decision was made partly with model-based analyses from cancer intervention and surveillance modeling network (CISNET), which assumed perfect compliance to screening.Methods: As part of CISNET, we developed a microsimulation model for lung cancer (LC) screening and calibrated and validated it using data from NLST and the prostate, lung, colorectal, and ovarian cancer screening trial (PLCO), respectively. We evaluated population-level outcomes of the lifetime screening program recommended by the USPSTF by varying screening compliance levels.Results: Validation using PLCO shows that our model reproduces observed PLCO outcomes, predicting 884 LC cases [Expected(E)/Observed(O) = 0.99; CI 0.92-1.06] and 563 LC deaths (E/O = 0.94 CI 0.87-1.03) in the screening arm that has an average compliance rate of 87.9% over four annual screening rounds. We predict that perfect compliance to the USPSTF recommendation saves 501 LC deaths per 100,000 persons in the 1950 U.S. birth cohort; however, assuming that compliance behaviors extrapolated and varied from PLCO reduces the number of LC deaths avoided to 258, 230, and 175 as the average compliance rate over 26 annual screening rounds changes from 100 to 46, 39, and 29%, respectively.Conclusion: The implementation of the USPSTF recommendation is expected to contribute to a reduction in LC deaths, but the magnitude of the reduction will likely be heavily influenced by screening compliance.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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