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Life-Gained Selection Maximizes Lung Cancer Screening Benefits

Selection based on gains in life expectancy can increase total life expectancy from CT screening

MONDAY, Oct. 21, 2019 (HealthDay News) — Selection of ever-smokers for lung cancer screening based on gains in life expectancy can increase total life expectancy from screening but prevents fewer lung cancer deaths, according to a study published online Oct. 22 in the Annals of Internal Medicine.

Li C. Cheung, Ph.D., from the National Cancer Institute in Bethesda, Maryland, and colleagues compared selection of ever-smokers for screening based on gains in life expectancy versus lung cancer risk in a U.S. population of ever-smokers aged 40 to 84 years. Data were included for 130,964 National Health Interview Survey participants, representing about 60 million U.S. ever-smokers.

The researchers found that using the calibrated and validated mortality model and selecting 8.3 million ever-smokers to match the number selected by the U.S. Preventive Services Task Force criteria in 2013 and 2015, life-gained-based selection compared with risk-based selection would increase the total life expectancy from computed tomography screening to 633,400 versus 607,800 years, but it would prevent fewer lung cancer deaths (52,600 versus 55,000). Younger individuals (mean age, 59 versus 75 years) and those with fewer comorbidities (mean, 0.75 versus 3.7) were among the 1.56 million persons selected by the life-gained-based strategy but not the risk-based strategy.

“Our life-gained-based framework could aid in the development of lung cancer screening guidelines such that benefits are maximized; harms are minimized; and the number of prevented deaths, effectiveness, and efficiency are maintained at high levels,” the authors write.

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