Detail (Long)
Offer low-dose CT screening to asymptomatic pts not meeting age or smoking criteria for screening who are projected to have a high net benefit from screening according to calculated thresholds (e.g., ≥2.6% over 6y on PLCOm2012 calculator).<sup>1</sup><br>
◦ <b>Risk-prediction calculators.</b><sup>1</sup> Calculators reflect variables that contribute to ↑all-cause mortality and ↑screening-related morbidity. Augmenting screening criteria w/ risk-prediction and life-year gained calculators leads to greater equity across race and sex in screening eligibility and net benefits of screening.<br>
◦ Life-year gained calculators combine results of risk prediction and life expectancy estimates into 1 measure.<sup>1</sup><br>
◦ NCCN recommends using the <b>Tammemagi risk calculator</b> to identify pts at higher risk.<sup>3</sup> (<b>epocrates note:</b> This calculator uses risk corrections based on pt race. The validity of such corrections has been called into question, may lead to over- or under-estimation of risk based on race). <a href="https://online.epocrates.com/medCalc/LungCancerScreening.htm?activeMedCalcName=Lung%20Cancer%20Risk%20Estimation%20in%20Current%20and%20Past%20Smokers%20(6-year)"><u>Lung Cancer Risk Estimation in Current and Past Smokers (6-year)</u></a><br>
◦ <b>Additional risk factors:</b><sup>3</sup> personal hx of CA (previous lymphoma, head/neck, smoking related), COPD, pulm fibrosis, radon exposure, occupational carcinogen exposure, FHx lung CA in 1st-degree relative.<br><br>
◦ <b>Risk-prediction calculators.</b><sup>1</sup> Calculators reflect variables that contribute to ↑all-cause mortality and ↑screening-related morbidity. Augmenting screening criteria w/ risk-prediction and life-year gained calculators leads to greater equity across race and sex in screening eligibility and net benefits of screening.<br>
◦ Life-year gained calculators combine results of risk prediction and life expectancy estimates into 1 measure.<sup>1</sup><br>
◦ NCCN recommends using the <b>Tammemagi risk calculator</b> to identify pts at higher risk.<sup>3</sup> (<b>epocrates note:</b> This calculator uses risk corrections based on pt race. The validity of such corrections has been called into question, may lead to over- or under-estimation of risk based on race). <a href="https://online.epocrates.com/medCalc/LungCancerScreening.htm?activeMedCalcName=Lung%20Cancer%20Risk%20Estimation%20in%20Current%20and%20Past%20Smokers%20(6-year)"><u>Lung Cancer Risk Estimation in Current and Past Smokers (6-year)</u></a><br>
◦ <b>Additional risk factors:</b><sup>3</sup> personal hx of CA (previous lymphoma, head/neck, smoking related), COPD, pulm fibrosis, radon exposure, occupational carcinogen exposure, FHx lung CA in 1st-degree relative.<br><br>