Prospective Evaluation of Lung Cancer Screening Eligibility Criteria and Lung Cancer Detection in the Yorkshire Lung Screening Trial
Year: 2024
Type: article
Abstract: Introduction Low-dose computed tomography screening for lung cancer reduces lung cancer mortality, but there is a lack of international consensus regarding the optimal eligibility criteria for screening. The Yorkshire Lung Screening Trial was designed to evaluate lung cancer screening (LCS) implementation, and a primary objective was prospective evaluation of three predefined eligibility criteria. Methods Individuals who had ever smoked, aged 55 to 80 years, who responded to written invitation, underwent telephone risk assessment and if eligible by at least one criterion (PLCO M2012 ≥ 1.51%, LLP v2 ≥ 5%, USPSTF 2013 ) were offered biennial low-dose computed tomography screening. Results Of 44,957 individuals invited, 22,814 responded and underwent eligibility assessment, of whom a total of 7826 were eligible according to any of the three LCS criteria. Comparing PLCO M2012 ≥ 1.51%, LLP v2 ≥ 5%, and USPSTF 2013 , the proportions of responders eligible for screening were 28.0%, 20.5%, and 18.9%, respectively ( p < 0.0001 for each comparison), and the proportion of all cancers detected 91.1%, 77.0%, and 62.8%, respectively ( p ≤ 0.0002 for each comparison). When risk thresholds were selected to result in equivalent numbers of people eligible for screening, cancer detection proportions were higher for PLCO M2012 (74.5%) and LLP v2 (71.3%) than USPSTF 2013 (62.8%) ( p = 0.0002 and p = 0.032, respectively), but there was no significant difference between the two risk models. Reducing the LLPv2 risk threshold from 5% to 2.5% (as currently used in the English LCS program) and reducing the pack-year requirement for the USPSTF 2021 versus the USPSTF 2013 criteria increased the numbers eligible for screening, but subsequent cancer yield was not measured in this study. Conclusion The PLCO M2012 ≥ 1.51% criteria identified more people eligible for screening in Yorkshire Lung Screening Trial and resulted in more screen-detected lung cancers than LLP v2 ≥ 5% or USPSTF 2013 . When compared in equivalent populations, there was no significant difference between risk models in terms of lung cancer detection and each appeared more efficient at screening population selection than USPSTF 2013 .
Source: Journal of Thoracic Oncology
Authors: Rhian Gabe, Philip A.J. Crosbie, Daniel Vulkan, Hannah Bailey, David R. Baldwin, Claire Bradley, Richard Booton, Michael J. Darby, Claire Eckert, Neil Hancock, Sebastian Hinde, Sam M. Janes, Martyn P.T. Kennedy, Catriona Marshall, Henrik Moller, Rachael L. Murray, Richard D. Neal, Samantha L. Quaife, Suzanne Rogerson, Bethany Shinkins, Irene Simmonds, Sara Upperton, Matthew E.J. Callister
Institutions: Queen Mary University of London, University of Manchester, Leeds Teaching Hospitals NHS Trust, Nottingham University Hospitals NHS Trust, Manchester University NHS Foundation Trust, University of Leeds, University of York, University College London, Aalborg University, University of Nottingham, University of Exeter, University of Warwick
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,000
Funders: AstraZeneca, Roy Castle Lung Cancer Foundation, Yorkshire Cancer Research, Barts Charity, Cancer Research UK, National Institute for Health and Care Research, Prostate Cancer UK, University College London Hospitals NHS Foundation Trust, Samsung Biomedical Research Institute, Manchester Biomedical Research Centre, HORIZON EUROPE Framework Programme
OpenAlex ID: W4405613647