Estimation of Sojourn Time and Transition Probability of Lung Cancer for Smokers using the PLCO Data

Wang, Dengzhi; Levitt, Beth; Riley, Tom; Wu, Dongfeng

doi:10.4172/2155-6180.1000360

Cited by 3 publications

(6 citation statements)

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“…Secondly, we used the same estimate of MST across both genders and all ages as available subgroup‐specific data are still sparse. Slightly higher annual transition rates between preclinical and clinical LC have been reported for women than for the men 51 . In addition, more pronounced differences in MST could be expected for histological subtypes of LC than for age or sex.…”

Section: Discussionmentioning

confidence: 96%

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Low positive predictive value of computed tomography screening for lung cancer irrespective of commonly employed definitions of target population

Krilavičiūtė

Brenner

2021

Intl Journal of Cancer

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Screening for lung cancer (LC) by low‐dose computed tomography (LDCT) has been demonstrated to reduce LC mortality in randomized clinical trials (RCTs), and its implementation is in preparation in many countries. However, definition of the target population, which was based on various combinations of age ranges and definitions of heavy smoking in the RCTs, is subject to ongoing debate. Using epidemiological data from Germany, we aimed to estimate prevalence of preclinical LC and positive predictive value (PPV) of LDCT in potential target populations defined by age and smoking history. Populations aged 50 to 69, 55 to 69, 50 to 74 and 55 to 79 years were considered in this analysis. Sex‐specific prevalence of preclinical LC was estimated using LC incidence data within those age ranges and annual transition rates from preclinical to clinical LC obtained by meta‐analysis. Prevalence of preclinical LC among heavy smokers (defined by various pack‐year thresholds) within those age ranges was estimated by combining LC prevalence in the general population with proportions of heavy smokers and relative risks for LC among them derived from epidemiological studies. PPVs were calculated by combining these prevalences with sensitivity and specificity estimates of LDCT. Estimated prevalence of LC was 0.3% to 0.5% (men) and 0.2% to 0.3% (women) in the general population and 0.8% to 1.7% in target populations of heavy smokers. Estimates of PPV of LDCT were <20% for all definitions of target populations of heavy smokers. Refined preselection of target populations would be highly desirable to increase PPV and efficiency of LDCT screening and to reduce numbers of false‐positive LDCT findings.

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Section: Discussionmentioning

confidence: 96%

“…Slightly higher annual transition rates between preclinical and clinical LC have been reported for women than for the men. 51 In addition, more pronounced differences in MST could be expected for histological subtypes of LC than for age or sex. For instance, more aggressive small cell LC may have shorter MST than slow-growing cancers.…”

Section: Discussionmentioning

confidence: 99%

Low positive predictive value of computed tomography screening for lung cancer irrespective of commonly employed definitions of target population

Krilavičiūtė

Brenner

2021

Intl Journal of Cancer

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“…[18] Transition into the preclinical state could happen before age 50, and last until after age 90 from Figure 4. In Wang et al, [9] the transition probability increases all the way to age 80 for male smokers and has a peak around age 72. The key parameters obtained from this study are important, and reliable estimation is our priority.…”

Section: Discussionmentioning

confidence: 97%

“…We used the epidemiological method to estimate the sensitivity, the probability of getting a positive result given one is in the preclinical state, which is the same method as in Wang et al. [9] They found that the sensitivity was 0.65 for male and 0.68 for female smokers using the PLCO X-ray data.…”

Section: Discussionmentioning

confidence: 99%

“…Chien et al summarized several MST estimates ranging from 1.38-3.86 years from different CT scan [13]. In Wang et al, the MST for male was 1.50 and female was 1.74 years [9]. In the paper, Chen et al enlisted the MST values from previous researches and mentioned that the estimated MST with a 95%CI of range from 1.38 (0.63-3.18) to 3.86 (3.42-3.99) whereas the median and 95% CI of MST as a whole was estimated as 2.06 (0.42-3.83) years [14].…”

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confidence: 99%

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Inference of Sojourn Time and Transition Density using the NLST X-ray Screening Data in Lung Cancer

Rahman

2021

MRAJ

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Aims: The aim of this study is to provide statistical inference of the sojourn time and the transition probability from the disease free to the preclinical state of lung cancer for male and female smokers using lung cancer data from the National Lung Screening Trial (NLST). Materials and Methods: We applied a likelihood function to the lung cancer data, to obtain Bayesian inference of the transition probability and the sojourn time distribution. A log-normal distribution was used for the transition probability density function multiplied by 30%, and a Weibull distribution was used to model the sojourn time in the preclinical state. Results: The estimate of screening sensitivity is 0.61 for males and 0.62 for females. Early transition happened before age 50 and lasted until after age 90. The transition probability from the disease free to the preclinical state has a single maximum at around age 73 for males and 72 for females. For male, the Bayesian posterior mean, and median sojourn time are 1.33 and 1.27 years, respectively. For female, the corresponding posterior mean, and median sojourn time are 1.23 and 1.21 years, respectively. Conclusion: Our estimation showed that male smokers are more vulnerable to lung cancer, because they have a higher transition probability density than the same aged female smokers. The female smokers have a slightly shorter mean sojourn time than the male, meaning that they are quicker to develop clinical symptom of lung cancer.

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Lead time distribution for individuals with a screening history

Liu

Shesh

2021

Statistics and Its Interface

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We derived the distribution of lead time for periodic screening in the future when an individual has a screening history with negative results. It is a mixture of a point mass at zero and a positive sub-PDF. The motivation comes from the reality that for people in older age, they may already have some screening exams for targeted cancer before and still look healthy and are asymptomatic at their current age. How to evaluate their future screening result is a challenge. We explored how the screening history would affect the lead time if one would be diagnosed with cancer in the future. Simulations were carried out on combinations of different initial screening age, current age, sensitivity, mean sojourn time, and screening schedule in the past and in the future. The method developed can be applied to periodic exams for any kind of chronic disease, such as cancer. We applied our new method of evaluating the lead time distribution for male and female heavy smokers using low-dose computed tomography in the National Lung Screening Trial.

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Estimation of Sojourn Time and Transition Probability of Lung Cancer for Smokers using the PLCO Data

Cited by 3 publications

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Low positive predictive value of computed tomography screening for lung cancer irrespective of commonly employed definitions of target population

Low positive predictive value of computed tomography screening for lung cancer irrespective of commonly employed definitions of target population

Inference of Sojourn Time and Transition Density using the NLST X-ray Screening Data in Lung Cancer

Lead time distribution for individuals with a screening history

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