Lung cancer causes >1·6 million deaths annually, with early diagnosis being paramount to effective treatment. Here we present a validated risk assessment model for lung cancer screening. The prospective HUNT2 population study in Norway examined 65,237 people aged >20years in 1995-97. After a median of 15·2years, 583 lung cancer cases had been diagnosed; 552 (94·7%) ever-smokers and 31 (5·3%) never-smokers. We performed multivariable analyses of 36 candidate risk predictors, using multiple imputation of missing data and backwards feature selection with Cox regression. The resulting model was validated in an independent Norwegian prospective dataset of 45,341 ever-smokers, in which 675 lung cancers had been diagnosed after a median follow-up of 11·6years. Our final HUNT Lung Cancer Model included age, pack-years, smoking intensity, years since smoking cessation, body mass index, daily cough, and hours of daily indoors exposure to smoke. External validation showed a 0·879 concordance index (95% CI [0·866-0·891]) with an area under the curve of 0·87 (95% CI [0·85-0·89]) within 6years. Only 22% of ever-smokers would need screening to identify 81·85% of all lung cancers within 6years. Our model of seven variables is simple, accurate, and useful for screening selection.
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Cites: Eur Respir J. 2015 Mar;45(3):807-27 PMID 25657021
Cites: Int J Epidemiol. 2008 Jun;37(3):481-5 PMID 17984119
Cites: BMJ. 2017 Feb 8;356:j347 PMID 28179230
Cites: Am J Epidemiol. 2008 Feb 1;167(3):362-8 PMID 17982157
Cites: BMC Med Res Methodol. 2013 Mar 06;13:33 PMID 23496923
Cites: Am J Epidemiol. 2013 Apr 1;177(7):601-12 PMID 23425629
Cites: Cancer Prev Res (Phila). 2015 Sep;8(9):777-85 PMID 26076698
Cites: BMC Med Res Methodol. 2009 Jul 28;9:57 PMID 19638200