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@ARTICLE{TenHaaf:168953,
      author       = {K. Ten Haaf and C. M. van der Aalst and H. J. de Koning and
                      R. Kaaks$^*$ and M. C. Tammemägi},
      title        = {{P}ersonalising lung cancer screening: {A}n overview of
                      risk-stratification opportunities and challenges.},
      journal      = {International journal of cancer},
      volume       = {149},
      number       = {2},
      issn         = {1097-0215},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2021-01155},
      pages        = {250 - 263},
      year         = {2021},
      note         = {2021 Jul 15;149(2):250-263},
      abstract     = {Randomised 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.},
      subtyp        = {Review Article},
      keywords     = {lung cancer screening (Other) / personalised screening
                      (Other) / risk-based screening (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33783822},
      doi          = {10.1002/ijc.33578},
      url          = {https://inrepo02.dkfz.de/record/168953},
}