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Modeling of long-term screening for lung carcinoma
O Y Gorlova1, M Kimmel, C Henschke
1Department of Epidemiology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Background:
Results from the Mayo Lung Project (MLP), a randomized clinical trial for the early detection of lung carcinoma, were interpreted as proof that the early detection of lung carcinoma by chest X-ray does not reduce the mortality from this disease. Recent analysis of extended follow-up data from the MLP subjects found that after approximately 20 years there still was no apparent difference in lung carcinoma mortality between a study group and a control group.
Methods:
To view this result within context, the authors utilized a previously published simulation model of the MLP, with parametric values that were estimated at the time of the original publication based on the data collected by the MLP.
Results:
The model produced predictions of the extended follow-up statistics that were found to be consistent with the data published in the prior study. The authors believe this provides long-term validation for the model. Conversely, the same model demonstrated that had the study subjects been screened annually for the extended follow-up period, the difference in mortality would be noticeable, even with the low sensitivity of chest X-ray detection.
Conclusions:
The results of current study strongly suggest that long-term screening with chest X-ray results in a reduction in lung carcinoma mortality. The limited extent of this benefit is the result of the low sensitivity of chest X-ray as a screening tool.
