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LungCancerScreening:
Takingglobalimplementationforward
HarryJ.deKoning,MDPhDProfessorofPublicHealthScreeningEvaluationDeputyHeadDepartmentofPublicHealthErasmusMC,Rotterdam,theNetherlands
Conflictsofinterest
TheNELSONtrialissupportedby:SiemensGermanyprovidedworkstationsforuniformreadinginNELSONRocheDiagnosticsprovidedfundsforaside-studyonproteomicsNELSONPerceptronixprovidedfundsforasputumsidestudy(withseparateconsent)Departmentreceived/receivesresearchfundsfromNIH,EU,OntarioandSwissresearchfundsregardingLCcontrolNopersonalconflictsofinterestIwillnotdiscussofflabeluseand/orinvestigationaluseinmypresentation
100days
immuno-200days200daysLungcancer10.5years(3,800days)200daysCTscanLC
In:EuropeanGuideonQualityImprovementinComprehensiveCancerControl(2017)byTitAlbreht,R.KiasuwaM.vandenBulckeThestep-wisedecision-makingconcerningpotentialnewcancerscreeningprogrammesincludetheestablishmentofevidenceofeffectiveness,benefitsthatoutweightheharms,andcost-effectiveness.
SensitivityofCT-LCScreeningbyhistologyandstageCXRsensitivity:2.51%-97.31%CTsensitivity:8.83%-99.35%CT:3-foldhighersensitivityfordetectinglungcancerstageItenHaafetal.,CEBP2015
TheNationalLungScreeningTrialResearchTeam.NEnglJMed2011;365:395-409.CumulativeNumbersofLungCancersandofDeathsfromLungCancerNLST
?CISNETModelaverage1950cohortSHG1,followedfromages45-90(Annals2014)MISCAN-LungSHG2Full1950cohort,followedfromages55-100(newruns)MISCAN-LungSHG2Evereligibles1950cohort,followedfromages55-100(newruns)Proportioneverscreened**19.3%21.5%97.9%Benefits(per100,000)???Personsnolongerdyingoflungcancer4979014,200Life-yearsgained5,25011,74654,538LYG/deathprevented10.613.013.0Lungcancermortalityreduction14.0%17.7%30.9%Harms(per100,000)???TimespersonsundergoCTscreening
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