Precision Screening for Lung Cancer: Risk-Based but Not Always Preference-Sensitive?
Authors: Michael K. Gould
Journal: Annals of Internal Medicine (2018)

Editorials3 July 2018Precision Screening for Lung Cancer: Risk-Based but Not Always Preference-Sensitive?Michael K. Gould, MD, MSMichael K. Gould, MD, MSKaiser Permanente Southern California, Pasadena, California (M.K.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1350 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In lung cancer screening circles, one of the most hotly debated questions is whom to screen. As with many controversies, this one is about values and there is no single correct answer. The debate includes arguments from at least 4 camps, and each has merit. The “efficiency maximizers” believe that screening should be restricted to patients at the highest risk for lung cancer death to minimize waste and maximize the ratio of benefits to harms. In contrast, the goal of the “benefit maximizers” is to prevent as many deaths from lung cancer as possible, which leads them to favor liberal ...References1. Gould MK. Clinical practice. Lung-cancer screening with low-dose computed tomography. N Engl J Med. 2014;371:1813-20. [PMID: 25372089] doi:10.1056/NEJMcp1404071 CrossrefMedlineGoogle Scholar2. Torrance GW. Measurement of health state utilities for economic appraisal. J Health Econ. 1986;5:1-30. [PMID: 10311607] CrossrefMedlineGoogle Scholar3. Wolowacz SE, Briggs A, Belozeroff V, Clarke P, Doward L, Goeree R, et al. Estimating health-state utility for economic models in clinical studies: an ISPOR Good Research Practices Task Force report. Value Health. 2016;19:704-19. [PMID: 27712695] doi:10.1016/j.jval.2016.06.001 CrossrefMedlineGoogle Scholar4. Caverly TJ, Cao P, Hayward RA, Meza R. Identifying patients for whom lung cancer screening is preference-sensitive. A microsimulation study. Ann Intern Med. 2018;169:1-9. doi:10.7326/M17-2561 LinkGoogle Scholar5. Bach PB, Kattan MW, Thornquist MD, Kris MG, Tate RC, Barnett MJ, et al. Variations in lung cancer risk among smokers. J Natl Cancer Inst. 2003;95:470-8. [PMID: 12644540] CrossrefMedlineGoogle Scholar6. Bach PB, Gould MK. When the average applies to no one: personalized decision making about potential benefits of lung cancer screening. Ann Intern Med. 2012;157:571-3. [PMID: 22893040] LinkGoogle Scholar7. Kovalchik SA, Tammemagi M, Berg CD, Caporaso NE, Riley TL, Korch M, et al. Targeting of low-dose CT screening according to the risk of lung-cancer death. N Engl J Med. 2013;369:245-54. [PMID: 23863051] doi:10.1056/NEJMoa1301851 CrossrefMedlineGoogle Scholar8. Box GEP. Science and statistics. J Am Stat Assoc. 1976;71:791-9. doi:10.1080/01621459.1976.10480949 CrossrefGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Kaiser Permanente Southern California, Pasadena, California (M.K.G.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1350.Corresponding Author: Michael K. Gould, MD, MS, Department of Research and Evaluation, Kaiser Permanente Southern California, 300 South Los Robles Avenue, Suite 304, Pasadena, CA 91101; e-mail, Michael.k.[email protected]org.This article was published at Annals.org on 29 May 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIdentifying Patients for Whom Lung Cancer Screening Is Preference-Sensitive Tanner J. Caverly , Pianpian Cao , Rodney A. Hayward , and Rafael Meza Metrics Cited byPersonalised Lung Cancer Screening (PLuS) study to assess the importance of coexisting chronic conditions to clinical practice and policy: protocol for a multicentre observational studyPersonalized lung cancer screening: Are we ready to ENGAGE?Cancer prevention, risk reduction, and control: opportunities for the next decade of health care delivery researchPotential Impact of Cessation Interventions at the Point of Lung Cancer Screening on Lung Cancer and Overall Mortality in the United StatesThe potential impact of chronic obstructive pulmonary disease in lung cancer screening: implications for the screening clinicIdentifying Patients for Whom Lung Cancer Screening Is Preference-SensitiveRobert P. Young, BMedSc, MBChB, DPhil and Raewyn Hopkins, BN, MPH 3 July 2018Volume 169, Issue 1Page: 52-53KeywordsCancer screeningCyclic adenosine monophosphateDecision analysisDisclosureHealth economicsHealth surveysLife expectancyLung and intrathoracic tumorsLung cancer screeningQuality of life ePublished: 29 May 2018 Issue Published: 3 July 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...