Eligibility for low-dose computerized tomography screening among asbestos-exposed individuals

Area of Science:

• Environmental Health
• Oncology
• Public Health Modeling

Background:

• Asbestos exposure is a known risk factor for lung cancer.
• Accurate risk assessment is crucial for targeted cancer screening.
• Existing lung cancer models may not fully capture asbestos-related risks.

Purpose of the Study:

• To integrate asbestos exposure risk into the Canadian Cancer Risk Management Lung Cancer (CRMM-LC) microsimulation model.
• To determine optimal low-dose computerized tomography (LDCT) screening strategies for asbestos-exposed populations.
• To evaluate the cost-effectiveness of different screening frequencies and eligibility criteria.

Main Methods:

• Simulated an asbestos-exposed cohort within the CRMM-LC model.
• Modeled biennial low-dose computerized tomography (LDCT) screening scenarios.
• Assessed eligibility criteria based on smoking history and asbestos-induced relative risk (RR) for lung cancer.

Main Results:

• Biennial LDCT screening was modeled as cost-effective for asbestos-exposed individuals.
• Eligibility for biennial LDCT screening required a smoking history of ≥15 pack-years for those with a two-fold asbestos-induced lung cancer risk.
• Screening was cost-effective for non-smokers with an asbestos-induced RR of ≥10.

Conclusions:

• Asbestos-exposed individuals with a two-fold or greater lung cancer risk are eligible for biennial LDCT screening (ages 55-74) if they have smoked ≥15 pack-years.
• Lifelong non-smokers with asbestos exposure leading to an RR of ≥10 are eligible for biennial LDCT screening (ages 55-74).
• The refined model provides evidence-based recommendations for lung cancer screening in high-risk asbestos-exposed populations.