Blood-Based Biomarker Panel for Personalized Lung Cancer Risk Assessment

2022 ◽  
Author(s):  
Johannes F. Fahrmann ◽  
Tracey Marsh ◽  
Ehsan Irajizad ◽  
Nikul Patel ◽  
Eunice Murage ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Risk Assessment ◽  
Cancer Screening ◽  
Cancer Risk ◽  
Operating Characteristic ◽  
Lung Cancer Risk ◽  
Characteristic Curve ◽  
Lung Cancer Screening ◽  
Cancer Risk Assessment ◽  
Operating Characteristic Curve

PURPOSE To investigate whether a panel of circulating protein biomarkers would improve risk assessment for lung cancer screening in combination with a risk model on the basis of participant characteristics. METHODS A blinded validation study was performed using prostate lung colorectal ovarian (PLCO) Cancer Screening Trial data and biospecimens to evaluate the performance of a four-marker protein panel (4MP) consisting of the precursor form of surfactant protein B, cancer antigen 125, carcinoembryonic antigen, and cytokeratin-19 fragment in combination with a lung cancer risk prediction model (PLCOm2012) compared with current US Preventive Services Task Force (USPSTF) screening criteria. The 4MP was assayed in 1,299 sera collected preceding lung cancer diagnosis and 8,709 noncase sera. RESULTS The 4MP alone yielded an area under the receiver operating characteristic curve of 0.79 (95% CI, 0.77 to 0.82) for case sera collected within 1-year preceding diagnosis and 0.74 (95% CI, 0.72 to 0.76) among the entire specimen set. The combined 4MP + PLCOm2012 model yielded an area under the receiver operating characteristic curve of 0.85 (95% CI, 0.82 to 0.88) for case sera collected within 1 year preceding diagnosis. The benefit of the 4MP in the combined model resulted from improvement in sensitivity at high specificity. Compared with the USPSTF2021 criteria, the combined 4MP + PLCOm2012 model exhibited statistically significant improvements in sensitivity and specificity. Among PLCO participants with ≥ 10 smoking pack-years, the 4MP + PLCOm2012 model would have identified for annual screening 9.2% more lung cancer cases and would have reduced referral by 13.7% among noncases compared with USPSTF2021 criteria. CONCLUSION A blood-based biomarker panel in combination with PLCOm2012 significantly improves lung cancer risk assessment for lung cancer screening.

scholarly journals What is the effect of a decision aid on knowledge, values and preferences for lung cancer screening? An online pre–post study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045160
Author(s):  
Stephen D Clark ◽  
Daniel S Reuland ◽  
Alison T Brenner ◽  
Michael P Pignone
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Risk ◽  
Decision Aid ◽  
Lung Cancer Risk ◽  
Lung Cancer Screening ◽  
False Positives ◽  
Substantial Proportion ◽  
College Degree ◽  
Out Of Pocket Costs

ObjectiveTo examine if a decision aid improves knowledge of lung cancer screening benefits and harms and which benefits and harms are most valued.DesignPre–post study.SettingOnline.Participants219 current or former (quit within the previous 15 years) smokers ages 55–80 with at least 30 pack-years of smoking.InterventionLung cancer screening video decision aid.Main measuresScreening knowledge tested by 10 pre–post questions and value of benefits and harms (reducing chance of death from lung cancer, risk of being diagnosed, false positives, biopsies, complications of biopsies and out-of-pocket costs) assessed through rating (1–5 scale) and ranking (top three ranked).ResultsMean age was 64.7±6.1, 42.5% were male, 75.4% white, 48.4% married, 28.9% with less than a college degree and 67.6% with income <US$50 000. Knowledge improved postdecision aid (pre 2.8±1.8 vs post 5.8±2.3, diff +3.0, 95% CI 2.7 to 3.3; p<0.001). For values, reducing the chance of death from lung cancer was rated and ranked highest overall (rating 4.3±1.0; 59.4% ranked first). Among harms, avoiding complications (3.7±1.3) and out-of-pocket costs (3.7±1.2) rated highest. Thirty-four per cent ranked one of four harms highest: avoiding costs 13.2%, false positives 7.3%, biopsies 7.3%, complications 5.9%. Screening intent was balanced (1–4 scale; 1-not likely 21.0%, 4-very likely 26.9%). Those ‘not likely’ to screen had greater improvement in pre–post knowledge scores and more frequently ranked a harm first than those ‘very likely’ to screen (pre–post diff:+3.5 vs +2.6, diff +0.9; 95% CI 0.1 to 1.8; p=0.023; one of four harms ranked first: 28.4% vs 11.3%, p<0.001).ConclusionsOur decision aid increased lung cancer screening knowledge among a diverse sample of screen-eligible respondents. Although a majority valued ‘reducing the chance of death from lung cancer’ highest, a substantial proportion identified harms as most important. Knowledge improvement and ranking harms highest were associated with lower intention to screen.

PRELIMINARY LUNG CANCER RISK ASSESSMENT OF EXPOSURE TO RADON PROGENY FOR TRANSYLVANIA, ROMANIA

2010 ◽  
Vol 99 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Lucia-Adina Truta-Popa ◽  
Alexandra Dinu ◽  
Tiberius Dicu ◽  
Kinga Szacsvai ◽  
Constantin Cosma ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Risk Assessment ◽  
Cancer Risk ◽  
Lung Cancer Risk ◽  
Cancer Risk Assessment ◽  
Radon Progeny

scholarly journals Perspectives of family physicians towards access to lung cancer screening for individuals living with low income – a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ambreen Sayani ◽  
Mandana Vahabi ◽  
Mary Ann O’Brien ◽  
Geoffrey Liu ◽  
Stephen W. Hwang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Cancer Risk ◽  
Low Income ◽  
Lung Cancer Risk ◽  
Family Physicians ◽  
Lung Cancer Screening ◽  
Preventative Care ◽  
Systems Model

Abstract Background Individuals living with low income are less likely to participate in lung cancer screening (LCS) with low-dose computed tomography. Family physicians (FPs) are typically responsible for referring eligible patients to LCS; therefore, we sought to understand their perspectives on access to lung cancer screening for individuals living with low income in order to improve equity in access to LCS. Methods A theory-informed thematic analysis was conducted using data collected from 11 semi-structured interviews with FPs recruited from three primary care sites in downtown Toronto. Data was coded using the Systems Model of Clinical Preventative Care as a framework and interpretation was guided by the synergies of oppression analytical lens. Results Four overarching themes describe FP perspectives on access to LCS for individuals living with low income: the degree of social disadvantage that influences lung cancer risk and opportunities to access care; the clinical encounter, where there is often a mismatch between the complex health needs of low income individuals and structure of health care appointments; the need for equity-oriented health care, illustrated by the neglect of structural origins of health risk and the benefits of a trauma-informed approach; and finally, the multiprong strategies that will be needed in order to improve equity in health outcomes. Conclusion An equity-oriented and interdisciplinary team based approach to care will be needed in order to improve access to LCS, and attention must be given to the upstream determinants of lung cancer in order to reduce lung cancer risk.

scholarly journals Lung Cancer Risk Assessment due to Radon and Thoron Exposure in Dwellings in Ortum, Kenya

2021 ◽  
Vol 9 (2) ◽  
pp. 64-70
Author(s):  
F. Omonya Wanjala ◽  
N. O. Hashim ◽  
D. Otwoma ◽  
J. Kebwaro ◽  
M. Chege ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Risk Assessment ◽  
Cancer Risk ◽  
Lung Cancer Risk ◽  
Cancer Risk Assessment

scholarly journals Overcoming the pitfalls of current lung cancer risk assessment: Improved lung nodule characterization by a novel plasma protein biomarker test

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Gabriel Smester ◽  
J. Gabriel Medina ◽  
Christine Brown ◽  
Amanda L. Fish ◽  
Veronica Wells ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Risk Assessment ◽  
Cancer Risk ◽  
Plasma Protein ◽  
Lung Cancer Risk ◽  
Lung Nodule ◽  
Cancer Risk Assessment ◽  
Protein Biomarker

DOSIMETRIC AND EPIDEMIOLOGICAL APPROACHES TO RADON LUNG CANCER RISK ASSESSMENT

2019 ◽  
Vol 184 (3-4) ◽  
pp. 285-289
Author(s):  
J P Mc Laughlin
Keyword(s):  
Lung Cancer ◽  
Risk Assessment ◽  
Cancer Risk ◽  
Lung Cancer Risk ◽  
Epidemiological Studies ◽  
Cancer Risk Assessment ◽  
Radon Exposure ◽  
Conversion Factors

Abstract The two principal approaches used to assess the risk of lung cancer due to radon exposure are those based on dosimetric modelling and on epidemiology. Outline accounts are given of the main features of dosimetric models that have evolved over past decades. The main results of some occupational and residential epidemiological studies are also discussed. The doubling of the ICRP radon dose conversion factors estimated using the epidemiological based dose conversion convention in the period 1993–2010 are discussed. Also discussed is the more recent ICRP approach in which it is recommended that in future the doses should be estimated on the basis of dosimetric and biokinetic models thereby treating radon and its progeny as other radionuclides within its system of protection.

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