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Related Experiment Videos

Risk-Based Lung Cancer Screening in Clinical Practice.

Matthew M Rode1, Anne-Marie G Sykes2, Mark S Allen3

  • 1Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota.

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
|May 16, 2025
PubMed

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Summary
This summary is machine-generated.

Lung cancer screening using the PLCO risk calculator identified more cancers than USPSTF guidelines alone. Higher prospective risk correlated with increased lung cancer prevalence and incidence, with low invasive procedure rates.

Area of Science:

  • Pulmonology
  • Oncology
  • Radiology

Background:

  • Current U.S. lung cancer screening guidelines rely solely on age and smoking history.
  • Individualized risk assessment tools may offer superior risk stratification for lung cancer.

Purpose of the Study:

  • To evaluate the effectiveness of the PLCOm2012 risk calculator in identifying lung cancer.
  • To compare lung cancer detection rates between USPSTF2013 and PLCOm2012 criteria.

Main Methods:

  • A multisite lung cancer screening program enrolled patients qualifying via USPSTF2013 or PLCOm2012 (≥1.34% risk).
  • Retrospective abstraction of invasive procedures was performed.
  • Lung cancer incidence and prevalence were compared across risk strata defined by PLCOm2012.
Keywords:
Low-dose CTLung cancer screeningPulmonary nodulesRisk-based eligibility

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Main Results:

  • 114 lung cancers were detected in 2471 screened patients.
  • 84% of all patients and 91% of those diagnosed with cancer met both USPSTF2013 and PLCOm2012 criteria.
  • Lung cancer prevalence was over 7 times higher in the highest PLCOm2012 risk group compared to the lowest. Incidence was higher for PLCOm2012-only qualifiers (3.6/1000 person-years) versus USPSTF2013-only qualifiers (0/1000 person-years).
  • 74% of screen-detected NSCLC was Stage I or II. Invasive interventions for screening were low (4.3%).

Conclusions:

  • The PLCOm2012 risk calculator identifies more lung cancers, particularly in patients not meeting USPSTF2013 criteria alone.
  • Lung cancer prevalence and incidence increase with higher prospective risk scores.
  • Lung cancer screening using risk-based criteria demonstrates a low rate of invasive procedures for benign conditions.