Estimating lung cancer screening as treatment guidelines change
Principal Investigator
Name
Jon Steingrimsson
Degrees
Ph.D
Institution
Brown University
Position Title
Associate Professor of Biostatistics
About this CDAS Project
Study
NLST
(Learn more about this study)
Project ID
NLST-1531
Initial CDAS Request Approval
Aug 31, 2026
Title
Estimating lung cancer screening as treatment guidelines change
Summary
This project develops a framework for estimating the effectiveness of cancer screening as screening eligibility criteria and cancer treatment practices evolve. Randomized controlled trials provide strong evidence for screening effectiveness, but they are costly and time-consuming, and their findings may become less applicable as the target screening population and post-diagnosis treatments change. Our motivating application is lung cancer screening, where we aim to estimate the effect of low-dose computed tomography (LDCT) screening versus usual care in a contemporary screening-eligible population under current treatment practices. We will use data from NLST combined with data on treatment effectiveness to estimate treatment effects under contemporary lung cancer treatments.
Aims
- To combine evidence from NLST, PLCO, and data on treatment effectiveness. NLST will be used to inform the contrast between LDCT and chest radiography, while PLCO will be used to inform the contrast between chest radiography and usual care. We will furthermore evaluate how these estimates can be transported to a target population of all people in the US eligible for lung cancer screening but combining the datasets listed above with data from nationally representative surveys such as NHANES.
- To characterize positivity challenges that arise when eligibility criteria change over time. This is especially important when guidelines relax screening recommendations.
Collaborators
Jon Steingrimsson Brown University
MONICA COLON VARGAS Brown University
Jizhou Tian Brown University