Table 4.
Estimated outcomes of lung cancer screening under different eligibility strategies for current and former smokers aged 55–79 in fifteen state capital cities in Brazil, stratified by age group.
| Screening strategies |
||||
|---|---|---|---|---|
| All ever-smokers | Pack-years§ | Fixed risk threshold (1.2%)† | Age-specific risk thresholds | |
| Age 50–54 years (threshold=0.36%) | ||||
| Number of eligible individuals | 972,991 (938,923–1007,059) | 195,576 (173,355–217,797) | 3,313 (380–6,245) | 204,668 (183,002–226,335) |
| Percentage of eligible individuals | 100 | 20.1 | 0.3 | 21.0 |
| Lung cancer deaths in the absence of screening | 2,197 (2,055–2,339) | 1,139 (1,003–1,275) | 42 (5–80) | 1,214 (1,077–1,351) |
| Number of preventable lung cancer deaths eligible | 448 (419–477) | 2,32 (205–260) | 9 (1–16) | 248 (220–276) |
| Percentage of preventable lung cancer deaths eligible | 100 | 51.8 | 1.9 | 55.3 |
| NNS to prevent 1 lung cancer death | 2,171 (2,055–2,288) | 842 (799–885) | 385 (378–392) | 826 (793–860) |
| Age 55–59 years (threshold=0.64%) | ||||
| Number of eligible individuals | 764,833 (738,486–791,181) | 174,648 (153,788–195,508) | 54,903 (45,284–64,523) | 175,787 (156,823–194,751) |
| Percentage of eligible individuals | 100 | 22.8 | 7.2 | 23.0 |
| Lung cancer deaths in the absence of screening | 3,149 (2,945–3,354) | 1,780 (1,576–1,983) | 846 (697–995) | 1,873 (1,670–2,075) |
| Number of preventable lung cancer deaths eligible | 642 (601–684) | 363 (322–405) | 173 (142–203) | 382 (341–423) |
| Percentage of preventable lung cancer deaths eligible | 100 | 56.5 | 26.9 | 59.5 |
| NNS to prevent 1 lung cancer death | 1,191 (1,126–1,255) | 481 (456–505) | 318 (308–328) | 460 (443–477) |
| Age 60–64 years (threshold=0.99%) | ||||
| Number of eligible individuals | 679,383 (655,194–703,572) | 140,703 (123,591–157,815) | 104,858 (91,804–117,912) | 141,786 (126,508–157,065) |
| Percentage of eligible individuals | 100 | 20.7 | 15.4 | 20.9 |
| Lung cancer deaths in the absence of screening | 4,363 (4,063–4,663) | 2,433 (2,144–2,722) | 2,194 (1,908–2,481) | 2,595 (2,297–2,893) |
| Number of preventable lung cancer deaths eligible | 890 (829–951) | 496 (437–555) | 448 (389–506) | 529 (469–590) |
| Percentage of preventable lung cancer deaths eligible | 100 | 55.7 | 50.3 | 59.4 |
| NNS to prevent 1 lung cancer death | 763 (718–809) | 283 (263–303) | 234 (224–244) | 268 (256–280) |
| Age 65–69 years (threshold=1.55%) | ||||
| Number of eligible individuals | 410,597 (393,173–428,022) | 94,353 (81,555–107,151) | 144,045 (128,963–159,126) | 94,795 (82,191–107,400) |
| Percentage of eligible individuals | 100 | 23.0 | 35.1 | 23.1 |
| Lung cancer deaths in the absence of screening | 4,665 (4,228–5,101) | 2,808 (2,369–3,248) | 3,620 (3,175–4,064) | 2,942 (2,502–3,382) |
| Number of preventable lung cancer deaths eligible | 952 (863–1041) | 573 (483–663) | 738 (648–829) | 600 (510–690) |
| Percentage of preventable lung cancer deaths eligible | 100 | 60.2 | 77.5 | 63.0 |
| NNS to prevent 1 lung cancer death | 432 (398–465) | 165 (154–176) | 195 (183–207) | 158 (149–166) |
| Age 70–74 years (threshold=2.57%) | ||||
| Number of eligible individuals | 291,301 (276,618–305,984) | 61,918 (51,918–71,917) | 119,094 (106,358–131,831) | 62,130 (52,814–71,446) |
| Percentage of eligible individuals | 100 | 21.3 | 40.9 | 21.3 |
| Lung cancer deaths in the absence of screening | 4,880 (4,415–5,344) | 2,795 (2,341–3,250) | 4,020 (3,544–4,497) | 2,942 (2,490–3,395) |
| Number of preventable lung cancer deaths eligible | 995 (901–1090) | 570 (478–663) | 820 (723–917) | 600 (508–693) |
| Percentage of preventable lung cancer deaths eligible | 100 | 57.3 | 82.4 | 60.3 |
| NNS to prevent 1 lung cancer death | 293 (270–316) | 109 (101–116) | 145 (136–154) | 104 (98–109) |
| Age 75–79 years (threshold=3.46%) | ||||
| Number of eligible individuals | 207,583 (195,026–220,139) | 40,626 (31,970–49,282) | 96,325 (83,783–108,868) | 40,590 (32,455–48,726) |
| Percentage of eligible individuals | 100 | 19.6 | 46.4 | 19.6 |
| Lung cancer deaths in the absence of screening | 4,403 (3,878–4,927) | 2,438 (1,917–2,959) | 3,728 (3,185–4,270) | 2,534 (2,016–3,053) |
| Number of preventable lung cancer deaths eligible | 898 (791–1005) | 497 (391–604) | 760 (650–871) | 517 (411–623) |
| Percentage of preventable lung cancer deaths eligible | 100 | 55.3 | 84.6 | 57.6 |
| NNS to prevent 1 lung cancer death | 231 (208–255) | 82 (75–89) | 127 (115–138) | 78 (73–84) |
*Eligibility by the Lung Cancer Death Risk Assessment Tool (LCDRAT) with 5-year risk thresholds defined individually by age group to select the same number of individuals as the pack-years strategy.
§
at least 30 pack-years smoked, and less than 15 years since quitting.
†
Eligibility by the Lung Cancer Death Risk Assessment Tool (LCDRAT) with a single threshold of 1.2% 5-year risk.