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| 245 | _ | _ | |a Overdiagnosis in lung cancer screening - estimates from the German Lung Cancer Screening Intervention Trial. |
| 260 | _ | _ | |a Bognor Regis |b Wiley-Liss |c 2021 |
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| 500 | _ | _ | |a #EA:C020#LA:C020#2021 Mar 1;148(5):1097-1105 / https://doi.org/10.1002/ijc.33295 |
| 520 | _ | _ | |a Overdiagnosis is a major potential harm of lung cancer screening; knowing its potential magnitude helps to optimize screening eligibility criteria. The German Lung Screening Intervention Trial ('LUSI') is a randomized trial among 4052 long-term smokers (2622 men), 50.3-71.9 years of age from the general population around Heidelberg, Germany, comparing five annual rounds of low-dose computed tomography (n=2029) with a control arm without intervention (n=2023). After a median follow-up of 9.77 years post-randomization and 5.73 years since last screening, 74 participants were diagnosed with lung cancer in the control arm and 90 in the screening arm: 69 during the active screening period; of which 63 screen-detected and 6 interval cancers. The excess cumulative incidence in the screening arm (N=16) represented 25.4% [95%CI -11.3, 64.3] of screen-detected cancer cases (N=63). Analyzed by histologic subtype, excess incidence in the screening arm appeared largely driven by adenocarcinomas. Statistical modeling yielded an estimated mean pre-clinical sojourn time (MPST) of 5.38 [4.76, 5.88] years and a screen-test sensitivity of 81.6 [74.4%, 88.8%] for lung cancer overall, all histologic subtypes combined. Based on modeling, we further estimated that about 48% (47.5% [43.2%, 50.7%]) of screen-detected tumors have a lead time ≥4 years, whereas about 33% (32.8% [28.4%, 36.1%]) have a lead time ≥6 years, 23% (22,6% [18,6%, 25,7%]) ≥8 years, 16% (15.6% [12,2%, 18,3%]) ≥10 years and 11% (10,7% [8,0%, 13,0%]) ≥12 years. The high proportions of tumors with relatively long lead times suggests a major risk of overdiagnosis for individuals with comparatively short remaining life expectancies. This article is protected by copyright. All rights reserved. |
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| 700 | 1 | _ | |a Kauczor, Hans-Ulrich |b 3 |
| 700 | 1 | _ | |a Heussel, Claus-Peter |b 4 |
| 700 | 1 | _ | |0 P:(DE-He78)a8ce1da94e91296e574e4849cfabd230 |a Hermann, Silke |b 5 |u dkfz |
| 700 | 1 | _ | |a Zeissig, Sylke Ruth |b 6 |
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| 700 | 1 | _ | |0 P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a |a Kaaks, Rudolf |b 8 |e Last author |u dkfz |
| 773 | _ | _ | |0 PERI:(DE-600)1474822-8 |a 10.1002/ijc.33295 |n 5 |p 1097-1105 |t International journal of cancer |v 148 |x 0020-7136 |y 2021 |
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