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Comparative performance of lung cancer risk models to define lung screening eligibility in the United Kingdom by Hilary A. Robbins; Karine Alcala; Anthony J. Swerdlow; Minouk J. Schoemaker; Nick Wareham; Ruth C. Travis; Philip A. J. Crosbie; Matthew Callister; David R. Baldwin; Rebecca Landy; Mattias Johansson is a Medicine article available to read on EtoBox.

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## Background The National Health Service England (NHS) classifies individuals as eligible for lung cancer screening using two risk prediction models, PLCOm2012 and Liverpool Lung Project-v2 (LLPv2). However, no study has compared the performance of lung cancer risk models in the UK. ## Methods We analysed current and former smokers aged 40–80 years in the UK Biobank (__N__ = 217,199), EPIC-UK (__N__ = 30,813), and Generations Study (__N__ = 25,777). We quantified model calibration (ratio of expected to observed cases, __E__/__O__) and discrimination (AUC). ## Results Risk discrimination in UK Biobank was best for the Lung Cancer Death Risk Assessment Tool (LCDRAT, AUC = 0.82, 95% CI = 0.81–0.84), followed by the LCRAT (AUC = 0.81, 95% CI = 0.79–0.82) and the Bach model (AUC = 0.80, 95% CI = 0.79–0.81). Results were similar in EPIC-UK and the Generations Study. All models overestimated risk in all cohorts, with __E__/__O__ in UK Biobank ranging from 1.20 for LLPv3 (95% CI = 1.14–1.27) to 2.16 for LLPv2 (95% CI = 2.05–2.28). Overestimation increased with area-level socioeconomic status. In the combined cohorts, USPSTF 2013 criteria classified 50.7% of future cases as screening eligi

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Author

Hilary A. Robbins; Karine Alcala; Anthony J. Swerdlow; Minouk J. Schoemaker; Nick Wareham; Ruth C. Travis; Philip A. J. Crosbie; Matthew Callister; David R. Baldwin; Rebecca Landy; Mattias Johansson

Publisher

Springer Science and Business Media LLC

Published

2021

Language

EN

Field

Medicine (Health Sciences)