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@ARTICLE{Li:180644,
author = {M. Li and L. Zhang and H. Charvat and M. E. Callister and
P. Sasieni and E. Christodoulou$^*$ and R. Kaaks$^*$ and M.
Johansson and A. L. Carvalho and S. Vaccarella and H. A.
Robbins},
title = {{T}he influence of postscreening follow-up time and
participant characteristics on estimates of overdiagnosis
from lung cancer screening trials.},
journal = {International journal of cancer},
volume = {151},
number = {9},
issn = {0020-7136},
address = {Bognor Regis},
publisher = {Wiley-Liss},
reportid = {DKFZ-2022-01449},
pages = {1491-1501},
year = {2022},
note = {2022 Nov 1;151(9):1491-1501},
abstract = {We aimed to explore the underlying reasons that estimates
of overdiagnosis vary across and within low-dose computed
tomography (LDCT) lung cancer screening trials. We conducted
a systematic review to identify estimates of overdiagnosis
from randomised controlled trials of LDCT screening. We then
analysed the association of Ps (the excess incidence of lung
cancer as a proportion of screen-detected cases) with
postscreening follow-up time using a linear random effects
meta-regression model. Separately, we analysed annual Ps
estimates from the US National Lung Screening Trial (NLST)
and German Lung Cancer Screening Intervention Trial (LUSI)
using exponential decay models with asymptotes. We conducted
stratified analyses to investigate participant
characteristics associated with Ps using the extended
follow-up data from NLST. Among 12 overdiagnosis estimates
from 8 trials, the postscreening follow-up ranged from 3.8
to 9.3 years, and Ps ranged from $-27.0\%$ (ITALUNG, 8.3
years follow-up) to $67.2\%$ (DLCST, 5.0 years follow-up).
Across trials, $39.1\%$ of the variation in Ps was explained
by postscreening follow-up time. The annual changes in Ps
were $-3.5\%$ and $-3.9\%$ in the NLST and LUSI trials,
respectively. Ps was predicted to plateau at $2.2\%$ for
NLST and $9.2\%$ for LUSI with hypothetical infinite
follow-up. In NLST, Ps increased with age from $-14.9\%$
(55-59 years) to $21.7\%$ (70-74 years), and time trends in
Ps varied by histological type. The findings suggest that
differences in postscreening follow-up time partially
explain variation in overdiagnosis estimates across lung
cancer screening trials. Estimates of overdiagnosis should
be interpreted in the context of postscreening follow-up and
population characteristics.},
keywords = {lung cancer screening (Other) / overdiagnosis (Other) /
randomised controlled trial (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:35809038},
doi = {10.1002/ijc.34167},
url = {https://inrepo02.dkfz.de/record/180644},
}