Benchmarking lung cancer screening programmes with adaptive screening frequency against the optimal screening
Mehdi Hemmati1,2, Sayaka Ishizawa1, Rafael Meza3
1Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Eclinicalmedicine
|January 7, 2025
Summary
Structured lung cancer screening, like adaptive biennial-to-annual schedules, can improve efficiency over annual screening. Personalized screening using the ENGAGE framework offers optimal results for lung cancer detection.
Area of Science:
- Pulmonary medicine and oncology research.
- Health services research and comparative effectiveness.
- Biostatistics and health economics modeling.
Background:
- Current lung cancer screening guidelines recommend annual screening for eligible individuals, but optimal frequency may vary.
- The impact of structured screening frequencies on lung cancer screening effectiveness and efficiency is not well understood.
- The ENGAGE framework offers dynamic, personalized lung cancer screening recommendations.
Purpose of the Study:
- To compare the effectiveness and efficiency of structured lung cancer screening programs against the dynamic ENGAGE framework.
- To evaluate fixed (annual/biennial) and adaptive screening frequencies.
- To assess screening strategies based on US Preventive Services Task Force 2021 eligibility criteria.
Main Methods:
- A comparative microsimulation study was conducted.
- Benchmarked structured screening programs (fixed and adaptive frequencies) against the ENGAGE framework.
- Assessed efficiency (screenings per death avoided/ever-screened individual) and effectiveness (QALYs gained, mortality reduction, detected cancers) using validated models.
Main Results:
- The ENGAGE framework demonstrated superior performance.
- Among structured strategies, adaptive biennial-to-annual screening at age 65 was most efficient, reducing screenings per death avoided by 24% and per ever-screened individual by 60% compared to TF2021.
- Fixed annual screening was most effective but least efficient; all strategies yielded similar QALYs gained.
Conclusions:
- Adaptive lung cancer screening strategies, transitioning from biennial to annual screening at a specific age, show promise for improved efficiency.
- These adaptive strategies warrant further investigation, particularly in resource-limited settings.
- Personalized screening approaches may offer advantages in lung cancer detection and resource allocation.
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