TY - JOUR
T1 - Prospective evaluation of lung cancer screening eligibility criteria and lung cancer detection in the Yorkshire Lung Screening Trial
AU - Gabe, Rhian
AU - Crosbie, Philip A J
AU - Vulkan, Daniel
AU - Bailey, Hannah
AU - Baldwin, David R
AU - Bradley, Claire
AU - Booton, Richard
AU - Darby, Michael
AU - Eckert, Claire
AU - Hancock, Neil
AU - Hinde, Sebastian
AU - Janes, Sam M
AU - Kennedy, Martyn P T
AU - Marshall, Catriona
AU - Moller, Henrik
AU - Murray, Rachael L
AU - Neal, Richard D
AU - Quaife, Samantha L
AU - Rogerson, Suzanne
AU - Shinkins, Bethany
AU - Simmonds, Irene
AU - Upperton, Sara
AU - Callister, Matthew E J
N1 - Copyright © 2024 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
PY - 2024/12/16
Y1 - 2024/12/16
N2 - INTRODUCTION: Low dose CT (LDCT) 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 (YLST) was designed to evaluate lung cancer screening (LCS) implementation and a primary objective was prospective evaluation of 3 pre-defined eligibility criteria.METHODS: Individuals who had ever smoked, aged 55-80yrs, who responded to written invitation, underwent telephone risk assessment and if eligible by at least one criteria (PLCO
M2012≥1.51%, LLP
v2≥5%, USPSTF
2013) were offered biennial LDCT screening.
RESULTS: Of 44,957 individuals invited, 22,814 responded and underwent eligibility assessment, of whom a total of 7,826 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 lung cancer screening programme) and reducing the pack-year requirement for the USPSTF2021 vs the USPSTF2013 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 YLST 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.
AB - INTRODUCTION: Low dose CT (LDCT) 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 (YLST) was designed to evaluate lung cancer screening (LCS) implementation and a primary objective was prospective evaluation of 3 pre-defined eligibility criteria.METHODS: Individuals who had ever smoked, aged 55-80yrs, who responded to written invitation, underwent telephone risk assessment and if eligible by at least one criteria (PLCO
M2012≥1.51%, LLP
v2≥5%, USPSTF
2013) were offered biennial LDCT screening.
RESULTS: Of 44,957 individuals invited, 22,814 responded and underwent eligibility assessment, of whom a total of 7,826 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 lung cancer screening programme) and reducing the pack-year requirement for the USPSTF2021 vs the USPSTF2013 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 YLST 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.
U2 - 10.1016/j.jtho.2024.12.016
DO - 10.1016/j.jtho.2024.12.016
M3 - Article
C2 - 39709114
SN - 1556-1380
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
ER -