Table 2.
Scenarios Presenting Expected Outcomes§ for 4 Individuals with Different Risk Profiles‡ and Whether Net Benefit is Sensitive to Variation in Preferences
| Individual | Overall Risk Profile (annual lung cancer risk) |
Median
Life Expectancy (years) |
Incremental Quality Adjusted Life- Days Gained (Base-case) |
Incremental Quality Adjusted Life- Days (Favor- screening) |
Incremental Quality Adjusted Life- Days (Anti- screening) |
Number Needed to Screen* |
False positives per death averted |
Preference Sensitive? |
|---|---|---|---|---|---|---|---|---|
| Person A | 60-year-old male at low risk (0.1%) | 23.5 | 4 days | 5 days | −6 days | 513 | 405 | Yes |
| Person B | 75-year-old female at low risk (0.2%) | 13.5 | 2 days | 4 days | −8 days | 355 | 279 | Yes |
| Person C | 60-year-old female at high risk (0.7%) | 18.5 | 17 days | 19 days | 6 days | 121 | 92 | No |
| Person D | 75-year-old male at high risk (1.2%) | 7.6 | 5 days | 8 days | −6 days | 126 | 93 | Yes |
Expected outcomes are for base-case assumptions regarding the sensitivity and specificity of low-dose computed tomography screening and assume a 10% rate of overdiagnosed lung cancers.
All individuals meet US Preventive Services Task Force eligibility criteria for low-dose computed tomography lung cancer screening.
Number needed to screen to prevent 1 lung cancer death after 6.5-years of follow-up
Lower risk for developing lung cancer due to the following combination of characteristics: Former smoker; 30 pack-years (20 cigarettes per day for 30 years); quit 13 years ago; no asbestos exposure (in addition to these individual attributes, the following individual attributes were also used in assigning histology, which impacts incremental quality adjusted life-year gains with screening: body mass index of 25; No chronic obstructive pulmonary disease; No personal history of cancer; No family history of lung cancer).
Higher risk for developing lung cancer due to the following combination of characteristics: Current smoker; 67.5 pack-years (30 cigarettes per day for 45 years); no asbestos exposure (in addition to these individual attributes, the following individual attributes were also used in assigning histology, which impacts incremental quality adjusted life-year gains with screening: body mass index of 25; Positive history of chronic obstructive pulmonary disease; No personal history of cancer; Positive family history of lung cancer).