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@ARTICLE{Krilaviciute:167631,
author = {A. Krilaviciute$^*$ and H. Brenner$^*$},
title = {{L}ow positive predictive value of computed tomography
screening for lung cancer irrespective of commonly employed
definitions of target population.},
journal = {International journal of cancer},
volume = {149},
number = {1},
issn = {1097-0215},
address = {Bognor Regis},
publisher = {Wiley-Liss},
reportid = {DKFZ-2021-00465},
pages = {58-65},
year = {2021},
note = {#EA:C070#LA:C070# / 149(1):58-65},
abstract = {Screening for lung cancer (LC) by low-dose computed
tomography (LDCT) has been demonstrated to reduce LC
mortality in randomized clinical trials (RCTs), and its
implementation is in preparation in many countries. However,
definition of the target population, which was based on
various combinations of age ranges and definitions of heavy
smoking in the RCTs, is subject to ongoing debate. Using
epidemiological data from Germany, we aimed to estimate
prevalence of preclinical LC and positive predictive value
(PPV) of LDCT in potential target populations defined by age
and smoking history. Populations aged 50-69, 55-69, 50-74
and 55-79 years were considered in this analysis.
Sex-specific prevalence of preclinical LC was estimated
using LC incidence data within those age ranges and annual
transition rates from preclinical to clinical LC obtained by
meta-analysis. Prevalence of preclinical LC among heavy
smokers (defined by various pack-year thresholds) within
those age ranges was estimated by combining LC prevalence in
the general population with proportions of heavy smokers and
relative risks for LC among them derived from
epidemiological studies. PPVs were calculated by combining
these prevalences with sensitivity and specificity estimates
of LDCT. Estimated prevalence of LC was $0.3-0.5\%$ (men)
and $0.2-0.3\%$ (women) in the general population and
$0.8-1.7\%$ in target populations of heavy smokers.
Estimates of PPV of LDCT were $<20\%$ for all definitions of
target populations of heavy smokers. Refined preselection of
target populations would be highly desirable to increase PPV
and efficiency of LDCT screening and to reduce numbers of
false positive LDCT findings.},
keywords = {lung cancer (Other) / pack-years (Other) / preclinical
cancer (Other) / predictive value (Other) / screening
(Other)},
cin = {C070 / C120 / HD01},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
I:(DE-He78)HD01-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:33634860},
doi = {10.1002/ijc.33522},
url = {https://inrepo02.dkfz.de/record/167631},
}