Benefits and harms of lung cancer screening strategies in Argentina: a modeling study

Abstract

[ABSTRACT]: Background: Argentina lacks formal recommendations for lung cancer screening (LCS). We modeled the potential benefits and harms of different national LCS strategies with low-dose computed tomography in Argentina. Methods: We adapted one of the Cancer Intervention and Surveillance Modeling Network (CISNET) LCS models to Argentina's epidemiologic and demographic context. Using inputs from Argentina's version of the Smoking History Generator, a microsimulation model that generates cohort-specific smoking histories by age and sex, we modeled 26 annual screening scenarios for the 1960 birth cohort, including the US Preventive Services Task Force (USPSTF) 2021 criteria (ages 50–80, ≥20 pack-years, currently smoke or ≤15 years since quitting (YSQ)) and the US National Lung Screening Trial (NLST) criteria (ages 55–74, ≥30 pack-years, currently smoke or ≤15 YSQ). Findings: For any given number of screens, scenarios with an upper screening age limit of 80 years yielded the greatest number of lung cancer deaths (LCD) averted, followed by those that relax the YSQ criterion. Under the USPSTF 2021 recommendation, 25·2% of the population would be eligible for LCS, resulting in 547 LCD averted and 7618 life-years gained (LYG) per 100,000 population; the expected relative reduction in LC mortality is 14·6%. Under the NLST criteria, 14·2% would be eligible for LCS, resulting in 289 LCD averted and 4466 LYG per 100,000 population, with a relative reduction in lung cancer mortality of 7·7%. Interpretation: Approaches extending the upper age limit and relaxing YSQ criteria are the most effective. Funding: IASLC Young Investigator Grant and NIH/NCI U01CA253858 grant.