Dataset Information

Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/μl.

ABSTRACT:

Objective

Lung cancer is the leading cause of non-AIDS-defining cancer deaths among HIV-infected individuals. Although lung cancer screening with low-dose computed tomography (LDCT) is endorsed by multiple national organizations, whether HIV-infected individuals would have similar benefit as uninfected individuals from lung cancer screening is unknown. Our objective was to determine the benefits and harms of lung cancer screening among HIV-infected individuals.

Design

We modified an existing simulation model, the Lung Cancer Policy Model, for HIV-infected patients.

Data sources

Veterans Aging Cohort Study, Kaiser Permanente Northern California HIV Cohort, and medical literature.

Target population

HIV-infected current and former smokers.

Time horizon

Lifetime.

Perspective

Population.

Intervention

Annual LDCT screening from ages 45, 50, or 55 until ages 72 or 77 years.

Main outcome measures

Benefits assessed included lung cancer mortality reduction and life-years gained; harms assessed included numbers of LDCT examinations, false-positive results, and overdiagnosed cases.

Results of base-case analysis

For HIV-infected patients with CD4 cell count at least 500 cells/μl and 100% antiretroviral therapy adherence, screening using the Centers for Medicare & Medicaid Services criteria (age 55-77, 30 pack-years of smoking, current smoker or quit within 15 years of screening) would reduce lung cancer mortality by 18.9%, similar to the mortality reduction of uninfected individuals. Alternative screening strategies utilizing lower screening age and/or pack-years criteria increase mortality reduction, but require more LDCT examinations.

Limitations

Strategies assumed 100% screening adherence.

Conclusion

Lung cancer screening reduces mortality in HIV-infected patients with CD4 cell count at least 500 cells/μl, with a number of efficient strategies for eligibility, including the current Centers for Medicare & Medicaid Services criteria.

SUBMITTER: Kong CY

PROVIDER: S-EPMC5991188 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/μl.

Kong Chung Yin CY Sigel Keith K Criss Steven D SD Sheehan Deirdre F DF Triplette Matthew M Silverberg Michael J MJ Henschke Claudia I CI Justice Amy A Braithwaite R Scott RS Wisnivesky Juan J Crothers Kristina K

AIDS (London, England) 20180601 10

<h4>Objective</h4>Lung cancer is the leading cause of non-AIDS-defining cancer deaths among HIV-infected individuals. Although lung cancer screening with low-dose computed tomography (LDCT) is endorsed by multiple national organizations, whether HIV-infected individuals would have similar benefit as uninfected individuals from lung cancer screening is unknown. Our objective was to determine the benefits and harms of lung cancer screening among HIV-infected individuals.<h4>Design</h4>We modified ...[more]

PMID: 29683843

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Dataset Information

Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/μl.

Objective

Design

Data sources

Target population

Time horizon

Perspective

Intervention

Main outcome measures

Results of base-case analysis

Limitations

Conclusion

Publications

Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/μl.

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