Model-based eligibility for lung cancer screening: Where theory meets practice
Menée à partir d'un modèle mathématique, cette étude analyse le rapport coût-efficacité d'un programme de dépistage du cancer du poumon par tomographie numérique à faible dose de rayonnements chez les fumeurs et anciens fumeurs présentant un risque élevé de décès par cancer du poumon
Although the NLST (National Lung Screening Trial) demonstrated that computed tomography (CT) screening for lung cancer is associated with a reduction in lung cancer deaths, it also showed that screening often detects noncancerous nodules that are the gateway to patients undergoing repeated imaging, biopsies, and unnecessary surgical resections. Postpublication analyses of the NLST data confirmed what Bach and colleagues (1) had predicted in simulation models, namely that lung cancer deaths within the cohort screened in the NLST would be heavily concentrated among persons whose lung cancer risk was particularly elevated. More refined risk stratification therefore might improve the risk–benefit tradeoff for lung cancer screening (2–4).
Annals of Internal Medicine , éditorial, 2017