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Eligibility for low-dose computerized tomography screening among asbestos-exposed individuals.
Pubmed ID
25837734 (View this publication on the PubMed website)
Scand J Work Environ Health. 2015 Jul; Volume 41 (Issue 4): Pages 407-12
Fitzgerald NR, Flanagan WM, Evans WK, Miller AB, Canadian Partnership against Cancer (CPAC) Cancer Risk Management (CRM) Lung Cancer Working
  • Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

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.

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