A modeling analysis to compare eligibility strategies for lung cancer screening in Brazil

In a new study, scientists from the International Agency for Research on Cancer (IARC), in collaboration with scientists from the Brazilian Instituto Nacional de Câncer and the United States National Cancer Institute, estimate the potential benefits of large-scale lung cancer screening by low-dose computed tomography in 15 state capital cities in Brazil, and compare different strategies to define the optimal target populations for screening programmes. The results of the study were published in the journal EClinicalMedicine.

The researchers estimated that, over 5 years, 21 500 lung cancer deaths might occur among 2.3 million Brazilian current and former smokers aged 55–79 years if no screening were conducted. They then estimated the number of people who would be screened, the number of lung cancer deaths that might be prevented, and the mean age of the eligible population for each of three potential screening strategies.

The authors found that different strategies for eligibility are expected to have impacts on the efficiency of screening and the mean age of the population screened in Brazil. Defining eligibility for screening based on a risk prediction model would be likely to prevent more lung cancer deaths than a strategy based on categories of pack-years and quit-years, but the mean age of the population screened would be older in the risk-based scenario (68 years vs 63 years). Overall, the researchers estimated that about 2500–3000 lung cancer deaths could be prevented by screening about 500 000 people. In the short term, this translates to averting about 60% of preventable lung cancer deaths by screening about 20% of current and former smokers in 15 state capital cities in Brazil.

As the implementation of lung cancer screening proceeds in different countries around the world, the analytical framework developed for this study can be used to guide further studies that provide country-specific evidence for the choice of eligibility strategies.

Miranda-Filho A, Charvat H, Bray F, Migowski A, Cheung LC, Vaccarella S, et al.
A modeling analysis to compare eligibility strategies for lung cancer screening in Brazil
EClinicalMedicine, Published online 31 October 2021;
https://doi.org/10.1016/j.eclinm.2021.101176

Read the article