Towards dynamic risk assessments in lung cancer screening

Abstract

Various lung cancer screening programmes and pilot studies are being implemented worldwide.1 Many of these programmes have identified and screened their first selection of individuals that meet the defined criteria for screening eligibility. Regardless of the chosen criteria, there will always be a group of individuals with risks close to but below the cut-off for eligibility, who may reach the eligibility threshold in future years. Approaches for risk reassessment of these individuals should be efficient in order to limit the costs and potential distress of contacting these individuals.2 Consequently, the study by Kumarasamy et al provides a timely and pragmatic approach for evaluating whether and when to reassess these ‘near-miss’ individuals.3 The study evaluated individuals who were approached for the International Lung Screening Trial from seven sites across Australia, Canada and Hong Kong, but were ineligible due to having a PLCOm2012 risk score of less than 1.51%.4 5 It finds that about 50.3% of these individuals reach this risk score before age 80, while 38.7% and 26.9% would do so before ages 75 and 70, respectively. Overall, of the participants eligible by age 80, 69.0% reached the 1.51% risk score within 10 years …