title: Eligibility for low-dose computerized tomography screening among asbestos-exposed individuals.
abstract: OBJECTIVE
  The study aimed to incorporate an estimate of risk for asbestos exposure in the Canadian Cancer Risk Management Lung Cancer (CRMM-LC) microsimulation model.
  
  
  METHODS
  In CRMM-LC, a 3-year probability of developing lung cancer can be derived from different risk profiles. An asbestos-exposed cohort was simulated and different scenarios of low-dose computerized tomography (LDCT) screening were simulated.
  
  
  RESULTS
  As annual LDCT screening among non-asbestos-exposed individuals is less cost-effective than biennial screening, all the scenarios modeled for an asbestos-exposed cohort were biennial. For individuals with a two-fold risk of asbestos-induced lung cancer to be eligible for biennial LDCT screening, a smoking history of ≥15 pack-years would be necessary. For non-smokers with asbestos exposure resulting in a relative risk (RR) for lung cancer, it is not cost-effective to screen those with a RR of 5, but it is cost-effective to screen those with a RR of 10 (the heavily exposed).
  
  
  CONCLUSIONS
  Asbestos-exposed individuals with an estimated two-fold or more risk of lung cancer from asbestos-exposure are eligible for LDCT screening at all ages from 55-74 years if they have a cigarette smoking history of ≥15 pack-years. Asbestos-exposed individuals who are lifelong non-smokers are eligible for LDCT screening at all ages from 55-74 years if they have accumulated a degree of asbestos exposure resulting in an estimated risk of lung cancer of ≥10.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. ab.miller@sympatico.ca.
authors.forename: Natalie R
authors.initials: NR
authors.lastname: Fitzgerald
authors.forename: William M
authors.initials: WM
authors.lastname: Flanagan
authors.forename: William K
authors.initials: WK
authors.lastname: Evans
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Miller
mesh_terms: D017677:Age Distribution; D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D001195:Asbestosis / Q000000981:diagnostic imaging* / Q000191:economics / Q000209:etiology; D002170:Canada; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics / Q000592:standards*; D004781:Environmental Exposure / Q000009:adverse effects; D017408:Guidelines as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000191:economics / Q000209:etiology; D008875:Middle Aged; D008962:Models, Theoretical; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects* / Q000191:economics / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000592:standards
chemical_list: D001194:Asbestos