Original article

Scand J Work Environ Health 2015;41(4):407-412    pdf full text

doi:10.5271/sjweh.3496

Eligibility for low-dose computerized tomography screening among asbestos-exposed individuals

by Fitzgerald NR, Flanagan WM, Evans WK, Miller AB

Objectives 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).

Conclusion 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.

This article refers to the following text of the Journal: 1994;20(4):235-242
The following article refers to this text: 2015;41(4):417-418
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