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@ARTICLE{Feng:292455,
author = {X. Feng and P. Goodley and K. Alcala and F. Guida and R.
Kaaks$^*$ and R. Vermeulen and G. S. Downward and C. Bonet
and S. M. Colorado-Yohar and D. Albanes and S. J. Weinstein
and M. Goldberg and M. Zins and C. Relton and A. Langhammer
and A. H. Skogholt and M. Johansson and H. A. Robbins},
title = {{E}valuation of risk prediction models to select lung
cancer screening participants in {E}urope: a prospective
cohort consortium analysis.},
journal = {The lancet / Digital health},
volume = {6},
number = {9},
issn = {2589-7500},
address = {London},
publisher = {The Lancet},
reportid = {DKFZ-2024-01722},
pages = {e614 - e624},
year = {2024},
abstract = {Lung cancer risk prediction models might efficiently
identify individuals who should be offered lung cancer
screening. However, their performance has not been
comprehensively evaluated in Europe. We aimed to externally
validate and evaluate the performance of several risk
prediction models that predict lung cancer incidence or
mortality in prospective European cohorts.We analysed 240
137 participants aged 45-80 years with a current or former
smoking history from nine European countries in four
prospective cohorts from the pooled database of the Lung
Cancer Cohort Consortium: the Alpha-Tocopherol,
Beta-Carotene Cancer Prevention Study (Finland), the
Nord-Trøndelag Health Study (Norway), CONSTANCES (France),
and the European Prospective Investigation into Cancer and
Nutrition (Denmark, Germany, Italy, Spain, Sweden, the
Netherlands, and Norway). We evaluated ten lung cancer risk
models, which comprised the Bach, the Prostate, Lung,
Colorectal, and Ovarian Cancer Screening Trial 2012 model
(PLCOm2012), the Lung Cancer Risk Assessment Tool (LCRAT),
the Lung Cancer Death Risk Assessment Tool (LCDRAT), the
Nord-Trøndelag Health Study (HUNT), the Optimized Early
Warning Model for Lung Cancer Risk (OWL), the University
College London-Death (UCLD), the University College
London-Incidence (UCLI), the Liverpool Lung Project version
2 (LLP version 2), and the Liverpool Lung Project version 3
(LLP version 3) models. We quantified model calibration as
the ratio of expected to observed cases or deaths and
discrimination using the area under the receiver operating
characteristic curve (AUC). For each model, we also
identified risk thresholds that would screen the same number
of individuals as each of the US Preventive Services Task
Force 2021 (USPSTF-2021), the US Preventive Services Task
Force 2013 (USPSTF-2013), and the Nederlands-Leuvens
Longkanker Screenings Onderzoek (NELSON) criteria.Among the
participants, 1734 lung cancer cases and 1072 lung cancer
deaths occurred within five years of enrolment. Most models
had reasonable calibration in most countries, although the
LLP version 2 overpredicted risk by more than $50\%$ in
eight countries (expected to observed ≥1·50). The
PLCOm2012, LCDRAT, LCRAT, Bach, HUNT, OWL, UCLD, and UCLI
models showed similar discrimination in most countries, with
AUCs ranging from 0·68 $(95\%$ CI 0·59-0·77) to 0·83
(0·78-0·89), whereas the LLP version 2 and LLP version 3
showed lower discrimination, with AUCs ranging from 0·64
$(95\%$ CI 0·57-0·72) to 0·78 (0·74-0·83). When pooling
data from all countries (but excluding the HUNT cohort),
$33·9\%$ (73 313 of 216 387) of individuals were eligible
by USPSTF-2021 criteria, which included $74·8\%$ (1185) of
lung cancers and $76·3\%$ (730) of lung cancer deaths
occurring over 5 years. Fewer individuals were selected by
USPSTF-2013 and NELSON criteria. After applying thresholds
to select a population of equal size to USPSTF-2021, the
PLCOm2012, LCDRAT, LCRAT, Bach, HUNT, OWL, UCLD, and UCLI,
models identified $77·6\%-79·1\%$ of future cases,
although they selected slightly older individuals compared
with USPSTF-2021 criteria. Results were similar for
USPSTF-2013 and NELSON.Several lung cancer risk prediction
models showed good performance in European countries and
might improve the efficiency of lung cancer screening if
used in place of categorical eligibility criteria.US
National Cancer Institute, l'Institut National du Cancer,
Cancer Research UK.},
keywords = {Humans / Lung Neoplasms: diagnosis / Lung Neoplasms:
mortality / Europe: epidemiology / Aged / Male / Female /
Middle Aged / Prospective Studies / Early Detection of
Cancer / Risk Assessment / Aged, 80 and over / Incidence /
Risk Factors},
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:39179310},
doi = {10.1016/S2589-7500(24)00123-7},
url = {https://inrepo02.dkfz.de/record/292455},
}