Risk-Targeted Lung Cancer Screening
Authors: Vaibhav Kumar, Joshua T. Cohen, Peter J. Neumann, David M. Kent
Journal: Annals of Internal Medicine (2018)

Letters7 August 2018Risk-Targeted Lung Cancer ScreeningVaibhav Kumar, MD, Joshua T. Cohen, PhD, Peter J. Neumann, ScD, and David M. Kent, MD, MSVaibhav Kumar, MDTufts Medical Center, Boston, Massachusetts (V.K., J.T.C., P.J.N., D.M.K.)Search for more papers by this author, Joshua T. Cohen, PhDTufts Medical Center, Boston, Massachusetts (V.K., J.T.C., P.J.N., D.M.K.)Search for more papers by this author, Peter J. Neumann, ScDTufts Medical Center, Boston, Massachusetts (V.K., J.T.C., P.J.N., D.M.K.)Search for more papers by this author, and David M. Kent, MD, MSTufts Medical Center, Boston, Massachusetts (V.K., J.T.C., P.J.N., D.M.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0237 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We acknowledge that our analysis focused on participants enrolled in NLST and thus is not directly germane to the question of cost-effectiveness of screening smokers excluded from this trial. Nevertheless, the fundamental point of our analysis—also shown by Dr. Cressman and colleagues (1) and applicable to high-risk, NLST-ineligible participants—is that those at the highest risk for lung cancer mortality have a high prevalence of clinical characteristics that adversely affect longevity, quality of life, and costs related to screening and management of both cancer- and noncancer-related findings. We agree with Dr. Cressman and colleagues that screening higher-risk patients substantially ...References1. Cressman S, Peacock SJ, Tammemägi MC, Evans WK, Leighl NB, Goffin JR, et al. The cost-effectiveness of high-risk lung cancer screening and drivers of program efficiency. J Thorac Oncol. 2017;12:1210-22. [PMID: 28499861] doi:10.1016/j.jtho.2017.04.021 CrossrefMedlineGoogle Scholar2. Ten Haaf K, Jeon J, Tammemägi MC, Han SS, Kong CY, Plevritis SK, et al. Risk prediction models for selection of lung cancer screening candidates: a retrospective validation study. PLoS Med. 2017;14:e1002277. [PMID: 28376113] doi:10.1371/journal.pmed.1002277 CrossrefMedlineGoogle Scholar3. Kent DM, Alsheikh-Ali A, Hayward RA. Competing risk and heterogeneity of treatment effect in clinical trials [Editorial]. Trials. 2008;9:30. [PMID: 18498644] doi:10.1186/1745-6215-9-30 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Tufts Medical Center, Boston, Massachusetts (V.K., J.T.C., P.J.N., D.M.K.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1401. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk-Targeted Lung Cancer Screening Vaibhav Kumar , Joshua T. Cohen , David van Klaveren , Djøra I. Soeteman , John B. Wong , Peter J. Neumann , and David M. Kent Risk-Targeted Lung Cancer Screening Sonya Cressman , Kevin ten Haaf , Stephen Lam , and Martin Tammemägi Metrics Cited byHealth Economics Tools and Precision Medicine: Opportunities and Challenges 7 August 2018Volume 169, Issue 3Page: 200-201KeywordsDisclosureLife expectancyLung and intrathoracic tumorsMorbidityMortalityProbability distributionQuality adjusted life yearsQuality of lifeRacial and ethnic issuesSocioeconomic status ePublished: 7 August 2018 Issue Published: 7 August 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...