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Lung cancer CT screening: are we ready to consider screening biennially in a subgroup of low-risk individuals?
  1. John K Field1,
  2. Stephen W Duffy2
  1. 1Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
  2. 2Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  1. Correspondence to Professor John K Field, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool L69 3BX, UK; j.k.field{at}liverpool.ac.uk and Professor Stephen W Duffy, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK; s.w.duffy{at}qmul.ac.uk

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Most published research on low-dose CT screening for lung cancer pertains to annual screening.1 Schreuder and colleagues explore the possibilities for extending the interscreening interval on an individual basis.2 Using data from the US National Lung Screening Trial,3 they build up a logistic regression model of risk of a lung cancer at the second annual screen or in the year following it, based on subject characteristics and radiological observations including nodule attributes at the first screen. The logistic model incorporates polynomial regression coefficients where appropriate. They compare their model with other possible prediction models for this specific endpoint and find it to be superior.

The authors conclude that there is scope for extending the interval for some screenees. From their model, they project that for different risk thresholds, at the second screen, 2558 (10.4%), 7544 (30.7%), 10 947 (44.6%), 16 710 (68.1%) and 20 023 (81.6%) of the 24 368 screens could have been omitted, at the cost of delayed diagnosis of 0 (0.0%), 8 (4.6%), 17 (9.8%), 44 (25.3%) and 70 (40.2%) of the 174 lung cancers, respectively.

These observations …

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