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Analysis of lung cancer risk model (PLCOM2012 and LLPv2) performance in a community-based lung cancer screening programme
- Source :
- Lebrett, M, Balata, H, Evison, M, Colligan, D, Duerden, R, Elton, P, Greaves, M, Howells, J, Irion, K, Karunaratne, D, Lyons, J, Mellor, S, Myerscough, A, Newton, T, Sharman, A, Smith, E, Taylor, B, Taylor, S, Walsham, A, Whittaker, J, Barber, P V, Tonge, J, Robbins, H A, Booton, R & Crosbie, P 2020, ' Analysis of lung cancer risk model (PLCOM2012 and LLPv2) performance in a community-based lung cancer screening programme ', Thorax . https://doi.org/10.1136/thoraxjnl-2020-214626
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- IntroductionLow-dose CT (LDCT) screening of high-risk smokers reduces lung cancer (LC) specific mortality. Determining screening eligibility using individualised risk may improve screening effectiveness and reduce harm. Here, we compare the performance of two risk prediction models (PLCOM2012 and Liverpool Lung Project model (LLPv2)) and National Lung Screening Trial (NLST) eligibility criteria in a community-based screening programme.MethodsEver-smokers aged 55–74, from deprived areas of Manchester, were invited to a Lung Health Check (LHC). Individuals at higher risk (PLCOM2012 score ≥1.51%) were offered annual LDCT screening over two rounds. LLPv2 score was calculated but not used for screening selection; ≥2.5% and ≥5% thresholds were used for analysis.ResultsPLCOM2012 ≥1.51% selected 56% (n=1429) of LHC attendees for screening. LLPv2 ≥2.5% also selected 56% (n=1430) whereas NLST (47%, n=1188) and LLPv2 ≥5% (33%, n=826) selected fewer. Over two screening rounds 62 individuals were diagnosed with LC; representing 87% (n=62/71) of 6-year incidence predicted by mean PLCOM2012 score (5.0%). 26% (n=16/62) of individuals with LC were not eligible for screening using LLPv2 ≥5%, 18% (n=11/62) with NLST criteria and 7% (n=5/62) with LLPv2 ≥2.5%. NLST eligible Manchester attendees had 2.5 times the LC detection rate than NLST participants after two annual screens (≈4.3% (n=51/1188) vs 1.7% (n=438/26 309); padjOR 2.50, 95% CI 1.11 to 5.64; p=0.028).ConclusionProspective comparisons of risk prediction tools are required to optimise screening selection in different settings. The PLCOM2012 model may underestimate risk in deprived UK populations; further research focused on model calibration is required.
- Subjects :
- Pulmonary and Respiratory Medicine
Community based
medicine.medical_specialty
business.industry
Incidence (epidemiology)
Specific mortality
medicine.disease
Screening programme
03 medical and health sciences
Risk model
0302 clinical medicine
030220 oncology & carcinogenesis
Internal medicine
medicine
National Lung Screening Trial
030212 general & internal medicine
Lung cancer
business
Lung cancer screening
Subjects
Details
- ISSN :
- 14683296 and 00406376
- Volume :
- 75
- Database :
- OpenAIRE
- Journal :
- Thorax
- Accession number :
- edsair.doi.dedup.....d9fafa43964751b4b7c20f1380a456f2