Estimating eligibility for lung cancer screening in an Australian cohort, including the effect of spirometry.
OBJECTIVE
To estimate the proportion of ever-smokers who are eligible for lung cancer screening in an Australian cohort, and to evaluate the effect of spirometry in defining chronic obstructive pulmonary disease (COPD) when assessing screening eligibility.


METHODS
Cross-sectional study of 3586 individuals aged 50-68 years who live in the Busselton Shire of Western Australia.


RESULTS
Proportion of ever-smokers eligible for lung cancer screening based on United States Preventive Services Task Force (USPSTF) criteria, and PLCOm2012 lung cancer risk > 1.5%. The effect of using self-reported COPD, symptoms consistent with COPD, or spirometry to define COPD for screening eligibility according to the PLCOm2012 criteria.


RESULTS
Of ever-smokers aged 55-68 years, 254 (20.1%) would be eligible for screening according to USPSTF criteria; fewer would be eligible according to PLCOm2012 criteria (225, 17.9%; P = 0.004). This is equivalent to 8.9-10.0% of the total population aged 55-68 years, which suggests about 450 000 individuals in Australia may be eligible for lung cancer screening. The proportions of eligible participants were not significantly different whether spirometry results or symptoms consistent with COPD were used to determine PLCOm2012 risk.


CONCLUSIONS
The proportion of ever-smokers in this population who were eligible for lung cancer screening was 17.9-20.1%. Using symptoms to define COPD is an appropriate surrogate measure for spirometry when determining the presence of COPD in this population. There are significant challenges for policy makers on how to identify and recruit these eligible individuals from the wider population.
Sir Charles Gairdner Hospital, Perth, WA fraser.brims@uwa.edu.au.
David
D
Manners
Busselton Population Medical Research Institute, Busselton, WA.
Jennie
J
Hui
Busselton Population Medical Research Institute, Busselton, WA.
Michael
M
Hunter
Sir Charles Gairdner Hospital, Perth, WA.
Alan
A
James
University of Western Australia, Perth, WA.
Matthew W
MW
Knuiman
Fiona Stanley Hospital, Perth, WA.
Annette
A
McWilliams
Sir Charles Gairdner Hospital, Perth, WA.
Siobhain
S
Mulrennan
Sir Charles Gairdner Hospital, Perth, WA.
Arthur W Bill
AW
Musk
Sir Charles Gairdner Hospital, Perth, WA.
Fraser Jh
FJ
Brims
D000368:Aged; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D004608:Eligibility Determination / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry