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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
Open AccessArticle

Implementing Low-Dose Computed Tomography Screening for Lung Cancer in Canada: Implications of Alternative At-Risk Populations, Screening Frequency, and Duration

1
McMaster University, Hamilton, ON, Canada
2
Statistics Canada, Ottawa, ON, Canada
3
Dalla Lana School of Public Health, Toronto, ON, Canada
4
Canadian Partnership Against Cancer, Toronto, ON, Canada
5
University of Ottawa, Ottawa, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2016, 23(3), 179-187; https://doi.org/10.3747/co.23.2988
Received: 11 March 2016 / Revised: 12 April 2016 / Accepted: 12 May 2016 / Published: 1 June 2016
Background: Low-dose computed tomography (LDCT) screening has been shown to reduce mortality from lung cancer; however, the optimal screening duration and “at risk” population are not known. Methods: The Cancer Risk Management Model developed by Statistics Canada for the Canadian Partnership Against Cancer includes a lung screening module based on data from the U.S. National Lung Screening Trial (NLST). The base-case scenario reproduces NLST outcomes with high fidelity. The impact in Canada of annual screening on the number of incident cases and life-years gained, with a wider range of age and smoking history eligibility criteria and varied participation rates, was modelled to show the magnitude of clinical benefit nationally and by province. Life-years gained, costs (discounted and undiscounted), and resource requirements were also estimated. Results: In 2014, 1.4 million Canadians were eligible for screening according to NLST criteria. Over 10 years, screening would detect 12,500 more lung cancers than the expected 268,300 and would gain 9200 life-years. The computed tomography imaging requirement of 24,000–30,000 at program initiation would rise to between 87,000 and 113,000 by the 5th year of an annual NLST-like screening program. Costs would increase from approximately $75 million to $128 million at 10 years, and the cumulative cost nationally over 10 years would approach $1 billion, partially offset by a reduction in the costs of managing advanced lung cancer. Conclusions: Modelling various ways in which LDCT might be implemented provides decision-makers with estimates of the effect on clinical benefit and on resource needs that clinical trial results are unable to provide.
Keywords: Lung cancer; screening; low-dose computed tomography; modelling; nlst; Canada Lung cancer; screening; low-dose computed tomography; modelling; nlst; Canada
MDPI and ACS Style

Evans, W.K.; Flanagan, W.M.; Miller, A.B.; Goffin, J.R.; Memon, S.; Fitzgerald, N.; Wolfson, M.C. Implementing Low-Dose Computed Tomography Screening for Lung Cancer in Canada: Implications of Alternative At-Risk Populations, Screening Frequency, and Duration. Curr. Oncol. 2016, 23, 179-187. https://doi.org/10.3747/co.23.2988

AMA Style

Evans WK, Flanagan WM, Miller AB, Goffin JR, Memon S, Fitzgerald N, Wolfson MC. Implementing Low-Dose Computed Tomography Screening for Lung Cancer in Canada: Implications of Alternative At-Risk Populations, Screening Frequency, and Duration. Current Oncology. 2016; 23(3):179-187. https://doi.org/10.3747/co.23.2988

Chicago/Turabian Style

Evans, W.K.; Flanagan, W.M.; Miller, A.B.; Goffin, J.R.; Memon, S.; Fitzgerald, N.; Wolfson, M.C. 2016. "Implementing Low-Dose Computed Tomography Screening for Lung Cancer in Canada: Implications of Alternative At-Risk Populations, Screening Frequency, and Duration" Curr. Oncol. 23, no. 3: 179-187. https://doi.org/10.3747/co.23.2988

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