Utility of the National Lung Screening Trial Criteria for Estimation of Lung Cancer in the Korean Population

Lee, Ye-Jin; Choi, Sun Mi; Lee, Jun Young; Lee, Chang‐Hoon; Lee, Sang‐Min; Yoo, Chul‐Gyu; Kim, Young Whan; Han, Sung Koo; Park, Young Sik

doi:10.4143/crt.2017.357

Cited by 6 publications

(11 citation statements)

References 16 publications

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“…Clinico-epidemiological studies based on big data, which aid our understanding of cancer incidence and outcomes, are increasing in Korea 212223. Although large numbers of patients are evaluated,9 comparisons with the general population remain difficult.…”

Section: Discussionmentioning

confidence: 99%

The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study

et al. 2019

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Background The numbers of patients on dialysis and their life expectancies are increasing. Reduced renal function is associated with an increased risk of cancer, but the cancer incidence and sites in dialysis patients compared with those of the general population require further investigation. We investigated the incidences of various cancers in dialysis patients in Korea and used national health insurance data to identify cancers that should be screened in dialysis clinics. Methods We accessed the Korean National Health Insurance Database and excerpted data using the International Classification of Disease codes for dialysis and malignancies. We included all patients who commenced dialysis between 2004 and 2013 and selected the same number of controls via propensity score matching. Results A total of 48,315 dialysis patients and controls were evaluated; of these, 2,504 (5.2%) dialysis patients and 2,201 (4.6%) controls developed cancer. The overall cancer risk was 1.54-fold higher in dialysis patients than in controls (adjusted hazard ratio, 1.71; 95% confidence interval, 1.61–1.81). The cancer incidence rate (incidence rate ratio [IRR], 3.27) was especially high in younger dialysis patients (aged 0–29 years). The most common malignancy of end-stage renal disease patients and controls was colorectal cancer. The major primary cancer sites in dialysis patients were liver and stomach, followed by the lung, kidney, and urinary tract. Kidney cancer exhibited the highest IRR (6.75), followed by upper urinary tract (4.00) and skin cancer (3.38). The rates of prostate cancer (0.54) and oropharyngeal cancer (0.72) were lower than those in the general population. Conclusion Dialysis patients exhibited a higher incidence of malignancy than controls. Dialysis patients should be screened in terms of colorectal, liver, lung, kidney and urinary tract malignancies in dialysis clinics.

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Section: Discussionmentioning

confidence: 99%

The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study

et al. 2019

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“…In this study population, 17.5% and 18.3% of ever-smokers met the NLST and USPSTF criteria, respectively. In a previous study, approximately 6.9% Korean representative population aged ≥40 years met the NLST criteria (39). In another study, approximately 20% Korean representative population aged 55-74 years met the NLST criteria (40).…”

Section: Discussionmentioning

confidence: 89%

“…In another study, approximately 20% Korean representative population aged 55-74 years met the NLST criteria (40). However, these studies included both never-smokers and smokers (39,40). Considering that 43.9% people aged ≥40 years were ever-smokers (39), the proportion of smokers who met the NLST criteria in Korean representative population would be approximately 15%-16%.…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies included both never-smokers and smokers (39,40). Considering that 43.9% people aged ≥40 years were ever-smokers (39), the proportion of smokers who met the NLST criteria in Korean representative population would be approximately 15%-16%. A study conducted in Korea including both never-smokers and smokers demonstrated that the NLST criteria is useful to identify high-risk population for lung cancer screening based on the comparison of cancer incidence ratio of 5.78 between individuals who met and those who did not meet the criteria (39).…”

Section: Discussionmentioning

confidence: 99%

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Risk-based prediction model for selecting eligible population for lung cancer screening among ever smokers in Korea

Park¹,

Kim²,

Lee³

et al. 2021

Transl Lung Cancer Res

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“…Despite the evidence in mortality reduction among the heavy smokers, the question on how to best identify the target population for screening remains open. Multiple studies showed that only approximately 20% to 30% of LC patients would have been eligible for screening with NLST criteria, meaning that 70% to 80% of LC would be missed by screening 27‐36 . LC screening recommendations in the United States are now in the process to be changed to screen a larger proportion of the population that might reduce the number of potentially missed LC.…”

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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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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Utility of the National Lung Screening Trial Criteria for Estimation of Lung Cancer in the Korean Population

Cited by 6 publications

References 16 publications

The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study

The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study

Risk-based prediction model for selecting eligible population for lung cancer screening among ever smokers in Korea

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

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