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@ARTICLE{Kaaks:165964,
      author       = {R. Kaaks$^*$ and S. Delorme$^*$},
      title        = {{L}ung {C}ancer {S}creening by {L}ow-{D}ose {C}omputed
                      {T}omography - {P}art 1: {E}xpected {B}enefits, {P}ossible
                      {H}arms, and {C}riteria for {E}ligibility and {P}opulation
                      {T}argeting [{L}ungenkrebs-{S}creening mittels
                      {N}iedrigdosis-{C}omputertomografie – {T}eil 1:
                      {E}rwarteter {N}utzen, mögliche {S}chäden und {K}riterien
                      für die {E}ignung und das {T}argeting der {B}evölkerung].},
      journal      = {RöFo},
      volume       = {193},
      number       = {5},
      issn         = {1438-9010},
      address      = {Stuttgart [u.a.]},
      publisher    = {Thieme},
      reportid     = {DKFZ-2020-02513},
      pages        = {527-536},
      year         = {2021},
      note         = {#EA:C020#LA:E010#2021 May;193(5):527-536},
      abstract     = {Trials in the USA and Europe have convincingly demonstrated
                      the efficacy of screening by low-dose computed tomography
                      (LDCT) as a means to lower lung cancer mortality, but also
                      document potential harms related to radiation, psychosocial
                      stress, and invasive examinations triggered by
                      false-positive screening tests and overdiagnosis. To ensure
                      that benefits (lung cancer deaths averted; life years
                      gained) outweigh the risk of harm, lung cancer screening
                      should be targeted exclusively to individuals who have an
                      elevated risk of lung cancer, plus sufficient residual life
                      expectancy. Overall, randomized screening trials show an
                      approximate 20 $\%$ reduction in lung cancer mortality by
                      LDCT screening. In view of declining residual life
                      expectancy, especially among continuing long-term smokers,
                      risk of being over-diagnosed is likely to increase rapidly
                      above the age of 75. In contrast, before age 50, the
                      incidence of LC may be generally too low for screening to
                      provide a positive balance of benefits to harms and
                      financial costs. Concise criteria as used in the NLST or
                      NELSON trials may provide a basic guideline for screening
                      eligibility. An alternative would be the use of risk
                      prediction models based on smoking history, sex, and age as
                      a continuous risk factor. Compared to concise criteria, such
                      models have been found to identify a 10 $\%$ to 20 $\%$
                      larger number of LC patients for an equivalent number of
                      individuals to be screened, and additionally may help
                      provide security that screening participants will all have a
                      high-enough LC risk to balance out harm potentially caused
                      by radiation or false-positive screening tests. · LDCT
                      screening can significantly reduce lung cancer mortality. ·
                      Screening until the age of 80 was shown to be efficient in
                      terms of cancer deaths averted; in terms of LYG relative to
                      overdiagnosis, stopping at a younger age (e. g. 75) may have
                      greater efficiency. · Risk models may improve the overall
                      net benefit of lung cancer screening.· Kaaks R, Delorme S.
                      Lung Cancer Screening by Low-Dose Computed Tomography - Part
                      1: Expected Benefits, Possible Harms, and Criteria for
                      Eligibility and Population Targeting. Fortschr Röntgenstr
                      2020; DOI: 10.1055/a-1290-7926.},
      subtyp        = {Review Article},
      cin          = {C020 / E010},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331 / I:(DE-He78)E010-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33212540},
      doi          = {10.1055/a-1290-7926},
      url          = {https://inrepo02.dkfz.de/record/165964},
}