Comparative analysis of 5 lung cancer natural history and screening models that reproduce outcomes of the NLST and PLCO trials. Issue 11 (27th February 2014)

• Record Type: Journal Article
• Authors: Meza, Rafael; ten Haaf, Kevin; Kong, Chung Yin; Erdogan, Ayca; Black, William C.; Tammemagi, Martin C.; Choi, Sung Eun; Jeon, Jihyoun; Han, Summer S.; Munshi, Vidit; van Rosmalen, Joost; Pinsky, Paul; McMahon, Pamela M.; de Koning, Harry J.; Feuer, Eric J.; Hazelton, William D.; Plevritis, Sylvia K.
• Is Part Of: Cancer. Volume 120:Issue 11(2014)
• Page Start: 1713
• Page End: 1724
• Publication Date: 2014-02-27
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28623
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr28623-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The National Lung Screening Trial (NLST) demonstrated that low‐dose computed tomography screening is an effective way of reducing lung cancer (LC) mortality. However, optimal screening strategies have not been determined to date and it is uncertain whether lighter smokers than those examined in the NLST may also benefit from screening. To address these questions, it is necessary to first develop LC natural history models that can reproduce NLST outcomes and simulate screening programs at the population level.</p> </sec> <sec id="cncr28623-sec-0002" sec-type="section"> <title>METHODS</title> <p>Five independent LC screening models were developed using common inputs and calibration targets derived from the NLST and the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO). Imputation of missing information regarding smoking, histology, and stage of disease for a small percentage of individuals and diagnosed LCs in both trials was performed. Models were calibrated to LC incidence, mortality, or both outcomes simultaneously.</p> </sec> <sec id="cncr28623-sec-0003" sec-type="section"> <title>RESULTS</title> <p>Initially, all models were calibrated to the NLST and validated against PLCO. Models were found to validate well against individuals in PLCO who would have been eligible for the NLST. However, all models required further calibration to PLCO to adequately capture LC outcomes in PLCO never‐smokers and light smokers. Final versions of all models produced incidence and mortality outcomes in the presence and absence of screening that were consistent with both trials.</p> </sec> <sec id="cncr28623-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>The authors developed 5 distinct LC screening simulation models based on the evidence in the NLST and PLCO. The results of their analyses demonstrated that the NLST and PLCO have produced consistent results. The resulting models can be important tools to generate additional evidence to determine the effectiveness of lung cancer screening strategies using low‐dose computed tomography. <bold><italic>Cancer</italic> 2014;120:1713–1724</bold>. © <italic>2014 American Cancer Society</italic>.</p> </sec> </abstract>