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Scan-based competing death risk model for re-evaluating lung cancer computed tomography screening eligibility
- Source :
- European Respiratory Journal, 59, 5, The European Respiratory Journal, 59(5):2101613. European Respiratory Society, European Respiratory Journal, 59, European respiratory journal, 59(5). European Respiratory Society
- Publication Year :
- 2022
-
Abstract
- BackgroundA baseline computed tomography (CT) scan for lung cancer (LC) screening may reveal information indicating that certain LC screening participants can be screened less, and instead require dedicated early cardiac and respiratory clinical input. We aimed to develop and validate competing death (CD) risk models using CT information to identify participants with a low LC risk and a high CD risk.MethodsParticipant demographics and quantitative CT measures of LC, cardiovascular disease and chronic obstructive pulmonary disease were considered for deriving a logistic regression model for predicting 5-year CD risk using a sample from the National Lung Screening Trial (n=15 000). Multicentric Italian Lung Detection data were used to perform external validation (n=2287).ResultsOur final CD model outperformed an external pre-scan model (CD Risk Assessment Tool) in both the derivation (area under the curve (AUC) 0.744 (95% CI 0.727–0.761) and 0.677 (95% CI 0.658–0.695), respectively) and validation cohorts (AUC 0.744 (95% CI 0.652–0.835) and 0.725 (95% CI 0.633–0.816), respectively). By also taking LC incidence risk into consideration, we suggested a risk threshold where a subgroup (6258/23 096 (27%)) was identified with a number needed to screen to detect one LC of 216 (versus 23 in the remainder of the cohort) and ratio of 5.41 CDs per LC case (versus 0.88). The respective values in the validation cohort subgroup (774/2287 (34%)) were 129 (versus 29) and 1.67 (versus 0.43).ConclusionsEvaluating both LC and CD risks post-scan may improve the efficiency of LC screening and facilitate the initiation of multidisciplinary trajectories among certain participants.
- Subjects :
- Pulmonary and Respiratory Medicine
Oncology
medicine.medical_specialty
Lung Neoplasms
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9]
Logistic regression
Risk Assessment
Internal medicine
medicine
Humans
Mass Screening
Lung cancer
Lung
Early Detection of Cancer
business.industry
Incidence (epidemiology)
Area under the curve
medicine.disease
Confidence interval
Women's cancers Radboud Institute for Health Sciences [Radboudumc 17]
medicine.anatomical_structure
Cohort
National Lung Screening Trial
business
Tomography, X-Ray Computed
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Subjects
Details
- ISSN :
- 09031936
- Database :
- OpenAIRE
- Journal :
- European Respiratory Journal, 59, 5, The European Respiratory Journal, 59(5):2101613. European Respiratory Society, European Respiratory Journal, 59, European respiratory journal, 59(5). European Respiratory Society
- Accession number :
- edsair.doi.dedup.....8f5e719d9c1a4e17d077ade506a3e03f