Selecting Candidates for Lung Cancer Screening: Implications for Effectiveness, Efficiency, Equity, and Implementation.

EditorialsMarch 2023Selecting Candidates for Lung Cancer Screening: Implications for Effectiveness, Efficiency, Equity, and ImplementationRenda Soylemez Wiener, MD, MPH and Michael K. Gould, MD, MSRenda Soylemez Wiener, MD, MPHCenter for Health Organization and Implementation Research, VA Boston Healthcare System, Boston, and The Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MassachusettsSearch for more papers by this author and Michael K. Gould, MD, MSDepartment of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CaliforniaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0230 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail To optimize population-level outcomes, guideline developers should consider how their recommendations will impact the National Academy of Medicine's 6 domains of high-quality care: effectiveness, efficiency, equity, patient-centeredness, safety, and timeliness (1). Microsimulation models to inform the 2021 U.S. Preventive Services Task Force (USPSTF) lung cancer screening (LCS) guidelines (2) suggested that using predicted risk for developing or dying of lung cancer to select candidates for LCS would be more effective at preventing lung cancer deaths and result in greater life-year gains than approaches based on categorical age and smoking cutoffs (3). The current study by Toumazis and colleagues (4) (including ...References1. Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Pr. 2001. [PMID: 25057539] doi:10.17226/10027 CrossrefMedlineGoogle Scholar2. Krist AH, Davidson KW, Mangione CM, et al; US Preventive Services Task Force. Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021;325:962-70. [PMID: 33687470] doi:10.1001/jama.2021.1117 CrossrefMedlineGoogle Scholar3. Meza R, Jeon J, Toumazis I, et al. Evaluation of the benefits and harms of lung cancer screening with low-dose computed tomography: modeling study for the US Preventive Services Task Force. JAMA. 2021;325:988-97. [PMID: 33687469] doi:10.1001/jama.2021.1077 CrossrefMedlineGoogle Scholar4. Toumazis I, Cao P, de Nijs K, et al. Risk model–based lung cancer screening: a cost-effectiveness analysis. Ann Intern Med. 2023;176:320-32. doi:10.7326/M22-2216 LinkGoogle Scholar5. Rivera MP, Katki HA, Tanner NT, et al. Addressing disparities in lung cancer screening eligibility and healthcare access. An official American Thoracic Society statement. Am J Respir Crit Care Med. 2020;202:e95-112. [PMID: 33000953] doi:10.1164/rccm.202008-3053ST CrossrefMedlineGoogle Scholar6. Han PKJ, Lary C, Black A, et al. Effects of personalized risk information on patients referred for lung cancer screening with low-dose CT. Med Decis Making. 2019;39:950-61. [PMID: 31631776] doi:10.1177/0272989X19875966 CrossrefMedlineGoogle Scholar7. Crothers K, Kross EK, Reisch LM, et al. Patients' attitudes regarding lung cancer screening and decision aids. A survey and focus group study. Ann Am Thorac Soc. 2016;13:1992-2001. [PMID: 27652509] doi:10.1513/AnnalsATS.201604-289OC CrossrefMedlineGoogle Scholar8. Rustagi AS, Byers AL, Keyhani S. Likelihood of lung cancer screening by poor health status and race and ethnicity in US adults, 2017 to 2020. JAMA Netw Open. 2022;5:e225318. [PMID: 35357450] doi:10.1001/jamanetworkopen.2022.5318 CrossrefMedlineGoogle Scholar9. Reese TJ, Schlechter CR, Kramer H, et al. Implementing lung cancer screening in primary care: needs assessment and implementation strategy design. Transl Behav Med. 2022;12:187-97. [PMID: 34424342] doi:10.1093/tbm/ibab115 CrossrefMedlineGoogle Scholar10. Aredo JV, Choi E, Ding VY, et al. Racial and ethnic disparities in lung cancer screening by the 2021 USPSTF guidelines versus risk-based criteria: the multiethnic cohort study. JNCI Cancer Spectr. 2022;6. [PMID: 35642317] doi:10.1093/jncics/pkac033 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Renda Soylemez Wiener, MD, MPH; Michael K. Gould, MD, MSAffiliations: Center for Health Organization and Implementation Research, VA Boston Healthcare System, Boston, and The Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MassachusettsDepartment of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CaliforniaNote: The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the U.S. government.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0230.Corresponding Author: Renda Soylemez Wiener, MD, MPH, CHOIR, VA Boston Healthcare System, 150 South Huntington Avenue (152M), Jamaica Plain Campus, Building 9, Boston, MA 02130; e-mail, renda.wiener@va.gov.This article was published at Annals.org on 7 February 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk Model–Based Lung Cancer Screening Iakovos Toumazis , Pianpian Cao , Koen de Nijs , Mehrad Bastani , Vidit Munshi , Mehdi Hemmati , Kevin ten Haaf , Jihyoun Jeon , Martin Tammemägi , G. Scott Gazelle , Eric J. Feuer , Chung Yin Kong , Rafael Meza , Harry J. de Koning , Sylvia K. Plevritis , and Summer S. Han Metrics March 2023Volume 176, Issue 3Page: 413-414KeywordsCancer screeningCost effectiveness analysisHealth screeningLung cancer screeningPreventive medicine ePublished: 7 February 2023 Issue Published: March 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...