Skip to Main Content
An official website of the United States government
Login Change: CDAS is now using the NIH Researcher Auth Service (RAS) to manage our existing login options. When logging into CDAS, you will be taken to RAS, where you can select your preferred login provider to access CDAS.

Heterogeneity of screening effects (Original Project: NLST-1098)

Principal Investigator

Name
Hormuzd Katki

Degrees
Ph.D.

Institution
American Cancer Society

Position Title
Scientific Vice President, Center for Early Cancer Detection

Email
hormuzd.katki@cancer.org

About this CDAS Project

Study
NLST (Learn more about this study)

Project ID
NLST-1509

Initial CDAS Request Approval
May 29, 2026

Title
Heterogeneity of screening effects (Original Project: NLST-1098)

Summary
We will examine heterogeneity of screening effects in NLST by various factors. This is because, screening individuals at the highest lung-cancer risk may be incorrect. Lung-cancer screening is most beneficial for individuals at both high risk of lung-cancer death and low risk of death from other causes (competing-mortality). That is, some high-risk individuals will have little benefit from lung-cancer screening, even if their lung-cancer death is prevented, because they would die from other causes shortly after. Unfortunately many lung-cancer risk-factors (e.g. smoking history, demographics) also increase the risk of competing-mortality via comorbidities such as lung disease, heart disease, or diabetes. Thus we will examine if the effect of screening is modified by factors that affect competing-mortality

Aims

How competing-mortality affects CT-screening effectiveness is unknown. We will analyze NLST data to calculate individualized competing-mortality risk (based on demographics, risk-factors, and comorbid conditions) and evaluate variation in the lung-cancer mortality reduction for CT-screening by quintiles of competing-mortality risk. We also examine variation in reduction in stage-4 lung-cancer incidence by quintiles of competing-mortality risk, because late-stage incidence is considered a reliable surrogate for mortality reductions from lung screening.
* We will look if risk factors (such as age, race, sex, etc) modify the effect of screening
* We will look at how effects of screening varying by screening test results
* We will focus on comorbidities, complications, and treatments

Collaborators

Li Cheung NCI
Hormuzd Katki American Cancer Society
Rebecca Landy American Cancer Society