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. 2015 Nov;69(11):1035-9.
doi: 10.1136/jech-2014-204079. Epub 2015 Jun 12.

Overdiagnosis in lung cancer screening: why modelling is essential

Kevin Ten Haaf  1 , Harry J de Koning  1
Affiliations

Overdiagnosis in lung cancer screening: why modelling is essential

Kevin Ten Haaf et al. J Epidemiol Community Health. 2015 Nov.
No abstract available

Keywords: CANCER; Cancer epidemiology; SCREENING.

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Conflict of interest statement

Competing interests

KtH and HJdK are members of the Cancer Intervention and Surveillance Modelling Network (CISNET) Lung working group. HJdK is the principal investigator of the Dutch-Belgian Lung Cancer Screening Trial (Nederlands-Leuvens Longkanker Screenings onderzoek; the NELSON trial). KtH is a researcher affiliated with the NELSON trial.

Figures

Figure 1
Figure 1
Lead-time and overdiagnosis. The two halves of the figure depict two scenarios: in the scenario depicted in the upper half of the figure, the person has developed a cancer that would have become symptomatic before the person would have died due to causes other than cancer. However, due to screening, this cancer is detected earlier. In the scenario depicted in the lower half of the figure, the person has developed a cancer that would not have become symptomatic before the person would have died due to causes other than cancer. However, due to screening, this cancer is detected, while it would not have been diagnosed without screening. The lead-time in both scenarios represents the time between the detection of the cancer by screening and the moment that the cancer would have become symptomatic.
Figure 2
Figure 2
Observed and estimated lung cancer incidence rate difference (per 1000 person-years) in the CT arm of the National Lung Screening Trial (NLST) compared to the chest radiography (CXR) arm by 1-year interval. Observed data derived from table S2–2 of Black et al. Error bars denote 95% CIs for the incidence rate difference. The MIcrosimulation SCreening ANalysis (MISCAN) Lung model was used to estimate the excess incidence of the CT arm compared to the CXR arm of the NLST and extrapolate beyond the follow-up duration of the trial.
Figure 3
Figure 3
Estimated lung cancer incidence rate difference (per 1000 person-years) of the CT and chest radiography (CXR) arms of the National Lung Screening Trial (NLST) compared to hypothetical non-screened arms by 1-year interval. The MIcrosimulation SCreening ANalysis (MISCAN) Lung model was used to estimate the excess incidence of the CT and CXR arms of the NLST compared to hypothetical arms in which screening did not occur.
See this image and copyright information in PMC

References

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