title: Comorbidities, smoking status, and life expectancy among individuals eligible for lung cancer screening.
abstract: BACKGROUND
  Lung cancer screening recommendations are based on results from the National Lung Screening Trial (NLST). The authors determined how the screening-eligible US population differs from NLST participants in terms of characteristics that affect their ability to benefit from screening.
  
  
  METHODS
  The authors identified respondents to the 2012 Health and Retirement Study (HRS), a national survey of individuals aged ≥50 years who are eligible for screening based on US Preventive Services Task Force and Centers for Medicare and Medicaid Services criteria. Comorbidities, life expectancy, smoking history, and other characteristics were compared between the screening-eligible population and NLST participants.
  
  
  RESULTS
  The authors estimated that in 2013, 8.4 million individuals (95% confidence interval, 7.9-8.9 million individuals) would have met the eligibility criteria for lung cancer screening established by the US Preventive Services Task Force. Compared with NLST participants, HRS screening-eligible respondents were older, more likely to be current smokers, and more likely to have been diagnosed with comorbidities. The 5-year survival rate was 87% in the HRS screening-eligible individuals versus 93% in the NLST participants (P<.001, based on a 2-sided test). Life expectancy was 18.7 years in the HRS screening-eligible individuals versus 21.2 years in the NLST participants.
  
  
  CONCLUSIONS
  The US population eligible for lung cancer screening is probably less likely to benefit from early detection than NLST participants because they face a high risk of death from competing causes. The results of the current study highlight the need for smoking cessation interventions targeting those patients eligible for screening and tools to help clinicians determine the potential benefits of screening in individual patients.
authors.affiliation: Department of Health Policy and Management, Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: David H
authors.initials: DH
authors.lastname: Howard
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Richards
authors.affiliation: Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Bach
authors.affiliation: Department of Behavior Science and Health Education, Emory University, Atlanta, Georgia.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Kegler
authors.affiliation: Department of Behavior Science and Health Education, Emory University, Atlanta, Georgia.
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Berg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D055088:Early Detection of Cancer; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008017:Life Expectancy; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D006278:Medicare; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D020521:Stroke / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: comorbidity; early detection of cancer; life expectancy; lung neoplasms; population characteristics; smoking