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Commonly Applied Selection Criteria for Lung Cancer Screening May Have Strongly Varying Diagnostic Performance in Different Countries
[journal article]
Abstract
Lung cancer (LC) screening often focuses heavy smokers as a target for screening group. Heavy smoking can thus be regarded as an LC pre-screening test with sensitivities and specificities being different in various populations due to the differences in smoking histories. We derive here expected sens... view more
Lung cancer (LC) screening often focuses heavy smokers as a target for screening group. Heavy smoking can thus be regarded as an LC pre-screening test with sensitivities and specificities being different in various populations due to the differences in smoking histories. We derive here expected sensitivities and specificities of various criteria to preselect individuals for LC screening in 27 European countries with diverse smoking prevalences. Sensitivities of various heavy-smoking-based pre-screening criteria were estimated by combining sex-specific proportions of people meeting these criteria in the target population for screening with associations of heavy smoking with LC risk. Expected specificities were approximated by the proportion of individuals not meeting the heavy smoking definition. Estimated sensitivities and specificities varied widely across countries, with sensitivities being generally higher among men (range: 33–80%) than among women (range: 9–79%), and specificities being generally lower among men (range: 48–90%) than among women (range: 70–99%). Major variation in sensitivities and specificities was also seen across different pre-selection criteria for LC screening within individual countries. Our results may inform the design of LC screening programs in European countries and serve as benchmarks for novel alternative or complementary tests for selecting people at high risk for CT-based LC screening. View Full-Text... view less
Keywords
cancer; early diagnosis; preventive medical examination; health care; smoking; tobacco consumption; Europe
Classification
Health Policy
Medicine, Social Medicine
Free Keywords
lung cancer; screening; smoking; sensitivity; specificity; ZA6861: Eurobarometer 87.1 (2017) (Data file Version 1.2.0)
Document language
English
Publication Year
2020
Page/Pages
p. 1-12
Journal
Cancers, 12 (2020) 10
Issue topic
Cancer Causes, Screening and Diagnosis
DOI
https://doi.org/10.3390/cancers12103012
ISSN
2072-6694
Status
Published Version; peer reviewed