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. Author manuscript; available in PMC: 2022 Dec 1.
Published in final edited form as: Cancer. 2021 Aug 12;127(23):4432–4446. doi: 10.1002/cncr.33835

Table 1a.

Expected outcomes for male ever-smokers by smoking status when the age at smoking initiation is 18 years, and for former smokers age at smoking cessation is 45 years, under alternative screening strategies (2013 USPSTF, Single-Threshold, ENGAGE).

Outcome Policy Former Light Smokers6 Former Moderate Smokers7 Former Heavy Smokers8 Current Light Smokers6 Current Moderate Smokers7 Current Heavy Smokers8
Total Expected QALYs 2 , n (95% CI) 2013 USPSTF 14.06 (14.04–14.07) 13.68 (13.67–13.70) 13.16 (13.14–13.18) 13.21 (13.19–13.23) 12.61 (12.59–12.63) 11.83 (11.81–11.85)
Single-threshold Risk-based1 14.06 (14.04–14.07) 13.67 (13.65–13.69) 13.16 (13.14–13.18)) 13.20 (13.18–13.22) 12.60 (12.59–12.62) 11.83 (11.81–11.85)
ENGAGE 14.06 (14.04–14.07) 13.68 (13.67–13.70) 13.18 (13.16–13.20) 13.21 (13.19–13.23) 12.62 (12.60–12.63) 11.84 (11.82–11.86)
Total Expected LYs 2 , n (95% CI) 2013 USPSTF 34.41 (34.35–34.47) 32.90 (32.84–32.96) 30.99 (30.93–31.06) 32.16 (32.09–32.22) 30.49 (30.42–30.55) 28.37 (28.31–28.43)
Single-threshold Risk-based1 34.41 (34.35–34.47) 32.93 (32.86–32.99) 31.06 (31.00–31.12) 32.24 (32.18–32.31) 30.51 (30.44–30.57) 28.40 (28.34–28.46)
ENGAGE 34.41 (34.35–34.47) 32.90 (32.84–32.96) 31.01 (30.95–31.08) 32.22 (32.15–32.28) 30.47 (30.41–30.54) 28.38 (28.32–28.44)
Lung Cancer Deaths 3 , n 2013 USPSTF 1,652 2,714 3,993 4,430 5,284 7,384
Single-threshold Risk-based1 1,652 2,342 3,067 3,380 4,968 6,986
ENGAGE 1,652 2,714 3,741 3,824 5,397 7,391
Mortality Reduction 4 , % 2013 USPSTF 0 0 4 <1 27 32
Single-threshold Risk-based1 0 14 26 24 32 35
ENGAGE 0 0 10 14 26 32
Ever-Screened Individuals 3 , % 2013 USPSTF 0 0 98.7 <1 77.7 98.0
Single-threshold Risk-based1 0 82.3 92.4 89.3 95.8 98.9
ENGAGE 0 0 94.3 76.9 97.6 99.1
LDCT Exams per Person Ever Screened, n (95% CI) 2013 USPSTF NA NA 5.84 (5.83–5.84) < 1 (<1-<1) 13.96 (13.90–14.02) 18.05 (18.01–18.09)
Single-threshold Risk-based1 NA 5.91 (5.89–5.93) 13.26 (13.22–13.29) 10.68 (10.64–10.72) 17.03 (16.99–17.07) 21.51 (21.46–21.56)
ENGAGE NA NA 4.30 (4.29–4.31) 5.02 (5.00–5.04) 11.25 (11.21–11.28) 16.93 (16.88–16.98)
LDCT Exams per Death Avoided, n 2013 USPSTF NA NA 3,944 613 696 523
Single-threshold Risk-based1 NA 1,590 1,234 1,016 734 559
ENGAGE NA NA 1,077 827 595 491
False-Positive Findings 3,5 , n 2013 USPSTF 0 0 49,731 52 109,316 142,222
Single-threshold Risk-based1 0 50,371 112,726 85,153 135,396 170,087
ENGAGE 0 0 36,818 38,777 87,748 132,983
Screen Detected Lung Cancers 3 2013 USPSTF 0 0 334 2 4,380 7,763
Single-threshold Risk-based1 0 840 2,371 2,349 5,071 8,667
ENGAGE 0 0 924 1,390 4,416 8,879
Early Stage 2013 USPSTF 0 0 263 2 3,586 6,276
Single-threshold Risk-based1 0 660 1,908 1,866 4,148 6,985
ENGAGE 0 0 709 1,084 3,565 7,129
Advanced Stage 2013 USPSTF 0 0 71 0 794 1,487
Single-threshold Risk-based1 0 180 463 483 923 1,682
ENGAGE 0 0 215 306 851 1,750

USPSTF, United States Preventive Services Task Force; QALYs, quality-adjusted life-years; LYs, life-years; LDCT, low-dose computed tomography

1

risk-based screening strategy using the Bach lung cancer risk prediction model between ages 50–80 with a static 1.91% 6-year risk threshold

2

per person at age 50

3

expected cases per 100,000 individuals from the general population

4

mortality reduction is estimated for the subpopulation of ever smokers that started smoking at age 18 and stopped smoking at age 45 for the former smokers

5

a false-positive finding is an abnormal LDCT exam (i.e. Lung-RADS category 3 or 4A) that is not diagnosed as cancer in a diagnostic follow-up management protocol

6

light smoker is defined as a person smoking on average 1–10 cigarettes per day

7

moderate smoker is defined as a person smoking on average 11–20 cigarettes per day

8

heavy smoker is defined as a person smoking on average >20 cigarettes per day