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000168953 041__ $$aEnglish
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000168953 1001_ $$00000-0001-5006-6938$$aTen Haaf, Kevin$$b0
000168953 245__ $$aPersonalising lung cancer screening: An overview of risk-stratification opportunities and challenges.
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000168953 500__ $$a2021 Jul 15;149(2):250-263
000168953 520__ $$aRandomised clinical trials have shown the efficacy of computed tomography lung cancer screening, initiating discussions on whether and how to implement population-based screening programs. Due to smoking behaviour being the primary risk-factor for lung cancer and part of the criteria for determining screening eligibility, lung cancer screening is inherently risk-based. In fact, the selection of high-risk individuals has been shown to be essential in implementing lung cancer screening in a cost-effective manner. Furthermore, studies have shown that further risk-stratification may improve screening efficiency, allow personalisation of the screening interval and reduce health disparities. However, implementing risk-based lung cancer screening programs also requires overcoming a number of challenges. There are indications that risk-based approaches can negatively influence the trade-off between individual benefits and harms if not applied thoughtfully. Large-scale implementation of targeted, risk-based screening programs has been limited thus far. Consequently, questions remain on how to efficiently identify and invite high-risk individuals from the general population. Finally, while risk-based approaches may increase screening program efficiency, efficiency should be balanced with the overall impact of the screening program. In this review, we will address the opportunities and challenges in applying risk-stratification in different aspects of lung cancer screening programs, as well as the balance between screening program efficiency and impact.
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000168953 650_7 $$2Other$$alung cancer screening
000168953 650_7 $$2Other$$apersonalised screening
000168953 650_7 $$2Other$$arisk-based screening
000168953 7001_ $$avan der Aalst, Carlijn M$$b1
000168953 7001_ $$00000-0003-4682-3646$$ade Koning, Harry J$$b2
000168953 7001_ $$0P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a$$aKaaks, Rudolf$$b3$$udkfz
000168953 7001_ $$aTammemägi, Martin C$$b4
000168953 773__ $$0PERI:(DE-600)1474822-8$$a10.1002/ijc.33578$$gVol. 149, no. 2, p. 250 - 263$$n2$$p250 - 263$$tInternational journal of cancer$$v149$$x1097-0215$$y2021
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