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Principal Investigator
Name
Martin Tammemagi
Degrees
DVM, MSc, PhD
Institution
Brock University
Position Title
Professor
Email
About this CDAS Project
Study
NLST (Learn more about this study)
Project ID
NLST-25
Initial CDAS Request Approval
Jul 22, 2013
Title
Do repeat normal lung screens lower model estimated baseline estimates of lung cancer risk?
Summary
It has been shown that enrolment into lung cancer screening programs using lung cancer risk based on accurate prediction models is more efficient than using National Lung Screening Trial entry criteria, and it is likely that if lung cancer screening programs are widely adopted in high-risk individuals in the future, enrolment will be based on model predicted elevated risk. It has been proposed that several repeat normal lung screens may suggest reduced lung cancer risk and may indicate that less than annual screening might be required for such individuals. Lung cancer risk prediction models, such as the Tammemagi PLCOm2012 model (NEJM 2013), provide lung cancer risk estimates at baseline excluding any subsequent lung cancer screening outcome data. Let's consider individuals with similar baseline lung cancer risks, but the one group has three consecutive negative screens and at the other extreme are individuals with three abnormal suspicious for lung cancer screens which turn out not diagnosed to be lung cancer within one year of the abnormal screen. In subsequent follow-up from T3 to T9 is lung cancer risk significantly lower in individuals with normal screens compared to those with abnormal suspicious for lung cancer screens. In this example, we contrasted clear cut opposites. If there is a real relationship, it is more likely to exist in a dose-response relationship. Our analytic plan would assess dose-response relationships.
Aims

The study aim is to determine whether baseline lung cancer risk in the NLST population as determined by the Tammemagi PLCOm2012 model (NEJM 2013) should be adjusted given three years screening results. The hypothesis is that normal screens reduce subsequent lung cancer risk and abnormal (suspicious for lung cancer) increase subsequent lung cancer risk.

Collaborators

Several collaborators have shown interest but a semi-final Study Team has not been confirmed. This field will be completed at a later date.