Table 2.
Aggregated population-level outcomes for ever-smokers with age at smoking initiation 18 years, and age at smoking cessation 45 years for former smokers, under alternative screening strategies
| Outcome | 2013 USPSTF | Single-Threshold Risk-Based1 | ENGAGE |
|---|---|---|---|
| Total Expected QALYs 2 , n (95% CI) | 13.17 (13.16–13.17) | 13.16 (13.16–13.17) | 13.18 (13.17–13.18) |
| Total Expected LYs 2 , n (95% CI) | 32.86 (32.84–32.88) | 32.91 (32.89–32.93) | 32.89 (32.87–32.90) |
| Lung Cancer Deaths 3 , n | 5,183 | 4,584 | 4,917 |
| Mortality Reduction 4 , % (95% CI) | 15 (14–16) | 25 (23–26) | 19 (18–20) |
| Ever-Screened Individuals 3 , n (%) | 61,243 (61.2) | 88,284 (88.3) | 77,953 (78.0) |
| LDCT Exams 3 | 739,130 | 1,333,974 | 812,788 |
| LDCT Exams per Person Ever Screened, n (95% CI) | 12.07 (12.04–12.10) | 15.11 (15.03–15.19) | 10.43 (10.40–10.45) |
| LDCT Exams per Death Avoided, n (95% CI) | 819 (817 to 821) | 889 (884 to 894) | 696 (694 to 697) |
| False-Positive Findings 3,5 , n | 59,420 | 108,999 | 65,125 |
| Screen Detected Lung Cancers 3 | 2,073 | 3,457 | 2,901 |
| Early Stage | 1,618 | 2,682 | 2,205 |
| Advanced Stage | 455 | 775 | 696 |
USPSTF, United States Preventive Services Task Force; QALYs, quality-adjusted life-years; LYs, life-years; LDCT, low-dose computed tomography
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
per person at age 50
expected cases per 100,000 individuals from the general population
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
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