Considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data

Abstract Low-dose computed tomography screening can be used to diagnose lung cancer at a younger age compared to no screening. Real-world studies observing mortality after lung cancer diagnosis are subject to lead-time bias. This study developed a method using a nationwide cancer registry and stage...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Szu-Chun Yang, Jung-Der Wang, Shi-Yi Wang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ea58d8495bae47c98e5d171cf56cb00c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:ea58d8495bae47c98e5d171cf56cb00c
record_format	dspace
spelling	oai:doaj.org-article:ea58d8495bae47c98e5d171cf56cb00c2021-12-02T17:52:23ZConsidering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data10.1038/s41598-021-91852-62045-2322https://doaj.org/article/ea58d8495bae47c98e5d171cf56cb00c2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91852-6https://doaj.org/toc/2045-2322Abstract Low-dose computed tomography screening can be used to diagnose lung cancer at a younger age compared to no screening. Real-world studies observing mortality after lung cancer diagnosis are subject to lead-time bias. This study developed a method using a nationwide cancer registry and stage shift from trial for the adjustment of lead-time bias. 78,897 Taiwanese nationwide lung cancer patients aged 55–82 were matched with 788,820 referents randomly selected from the general population at a ratio of 1:10 by age, sex, calendar year, and comorbidities, to estimate the pathology- and stage-specific life expectancy (LE). Loss-of-LE is the difference between the LE of cancer patients and that of referents. By multiplying LE and loss-of-LE by the pathology and stage shift in the National Lung Screening Trial (NLST), we compared the effectiveness of cancer screening measured by LE gained and loss-of-LE saved. The mean LEs of stage IA and IV adenocarcinoma were 14.5 and 1.9 years, respectively, indicating a LE gain of 12.6 years. However, the mean loss-of-LEs of stage IA and IV adenocarcinoma were 3.7 and 15.1 years, respectively, with a saving of only 11.4 years, implying an adjustment of different distributions of age, sex, and calendar year of diagnosis from stage shift and a reduction in lead-time bias. Applying such estimations on the results of 10,000 participants with the same pathology and stage shift in the NLST, the benefit of screening using LE gained would be 410.3 (95% prediction interval: 328.4 to 503.3) years. It became 297.1 (95% prediction interval: 187.8 to 396.4) years when using loss-of-LE saved, indicating the former approach would overestimate the effectiveness by 38%. Our approach of multiplying loss-of-LE by pathology and stage shift to estimate loss-of-LE saved could adjust for different distributions of age, sex, and calendar year at early diagnosis and reduce lead-time bias.Szu-Chun YangJung-Der WangShi-Yi WangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Szu-Chun Yang Jung-Der Wang Shi-Yi Wang Considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data
description	Abstract Low-dose computed tomography screening can be used to diagnose lung cancer at a younger age compared to no screening. Real-world studies observing mortality after lung cancer diagnosis are subject to lead-time bias. This study developed a method using a nationwide cancer registry and stage shift from trial for the adjustment of lead-time bias. 78,897 Taiwanese nationwide lung cancer patients aged 55–82 were matched with 788,820 referents randomly selected from the general population at a ratio of 1:10 by age, sex, calendar year, and comorbidities, to estimate the pathology- and stage-specific life expectancy (LE). Loss-of-LE is the difference between the LE of cancer patients and that of referents. By multiplying LE and loss-of-LE by the pathology and stage shift in the National Lung Screening Trial (NLST), we compared the effectiveness of cancer screening measured by LE gained and loss-of-LE saved. The mean LEs of stage IA and IV adenocarcinoma were 14.5 and 1.9 years, respectively, indicating a LE gain of 12.6 years. However, the mean loss-of-LEs of stage IA and IV adenocarcinoma were 3.7 and 15.1 years, respectively, with a saving of only 11.4 years, implying an adjustment of different distributions of age, sex, and calendar year of diagnosis from stage shift and a reduction in lead-time bias. Applying such estimations on the results of 10,000 participants with the same pathology and stage shift in the NLST, the benefit of screening using LE gained would be 410.3 (95% prediction interval: 328.4 to 503.3) years. It became 297.1 (95% prediction interval: 187.8 to 396.4) years when using loss-of-LE saved, indicating the former approach would overestimate the effectiveness by 38%. Our approach of multiplying loss-of-LE by pathology and stage shift to estimate loss-of-LE saved could adjust for different distributions of age, sex, and calendar year at early diagnosis and reduce lead-time bias.
format	article
author	Szu-Chun Yang Jung-Der Wang Shi-Yi Wang
author_facet	Szu-Chun Yang Jung-Der Wang Shi-Yi Wang
author_sort	Szu-Chun Yang
title	Considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data
title_short	Considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data
title_full	Considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data
title_fullStr	Considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data
title_full_unstemmed	Considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data
title_sort	considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ea58d8495bae47c98e5d171cf56cb00c
work_keys_str_mv	AT szuchunyang consideringleadtimebiasinevaluatingtheeffectivenessoflungcancerscreeningwithrealworlddata AT jungderwang consideringleadtimebiasinevaluatingtheeffectivenessoflungcancerscreeningwithrealworlddata AT shiyiwang consideringleadtimebiasinevaluatingtheeffectivenessoflungcancerscreeningwithrealworlddata
_version_	1718379260341649408

Considering lead-time bias in evaluating the effectiveness of lung cancer screening with real-world data

Ejemplares similares