Eligibility for low-dose computerized tomography screening among asbestos-exposed individuals

Scandinavian Journal of Work, Environment & Health

William M Flanagan¹  William K Evans¹  Anthony B Miller² 

[1] ;Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.;

关键词: risk factor;    exposure;    asbestos;    cancer;    smoking;    lung cancer;    asbestos exposure;    cost-effectiveness;    microsimulation;    mathematical modeling;    low-dose computerized tomography;    ct;   

DOI  :  10.5271/sjweh.3496

来源: DOAJ

【 摘 要 】

OBJECTIVES: The study aimed to incorporate an estimate of risk for asbestos exposure in the Canadian Cancer Risk Management Lung Cancer (CRMM-LC) microsimulation model. METHODS: In CRMM-LC, a 3-year probability of developing lung cancer can be derived from different risk profiles. An asbestos-exposed cohort was simulated and different scenarios of low-dose computerized tomography (LDCT) screening were simulated. RESULTS: As annual LDCT screening among non-asbestos-exposed individuals is less cost-effective than biennial screening, all the scenarios modeled for an asbestos-exposed cohort were biennial. For individuals with a two-fold risk of asbestos-induced lung cancer to be eligible for biennial LDCT screening, a smoking history of ≥15 pack-years would be necessary. For non-smokers with asbestos exposure resulting in a relative risk (RR) for lung cancer, it is not cost-effective to screen those with a RR of 5, but it is cost-effective to screen those with a RR of 10 (the heavily exposed). CONCLUSION: Asbestos-exposed individuals with an estimated two-fold or more risk of lung cancer from asbestos-exposure are eligible for LDCT screening at all ages from 55–74 years if they have a cigarette smoking history of ≥15 pack-years. Asbestos-exposed individuals who are lifelong non-smokers are eligible for LDCT screening at all ages from 55–74 years if they have accumulated a degree of asbestos exposure resulting in an estimated risk of lung cancer of ≥10.

【 授权许可】

Unknown