Small median tumor diameter at cure threshold (<20 mm) among aggressive non-small cell lung cancers in male smokers predicts both chest X-ray and CT screening outcomes in a novel simulation framework

dc.citation.firstpage189en_US
dc.citation.journalTitleInternational Journal of Canceren_US
dc.citation.lastpage197en_US
dc.citation.volumeNumber132en_US
dc.contributor.authorGoldwasser, Deborah L.en_US
dc.contributor.authorKimmel, Mareken_US
dc.date.accessioned2013-01-17T20:58:27Z
dc.date.available2014-01-18T06:10:05Z
dc.date.issued2013en_US
dc.description.abstractThe effectiveness of population-wide lung cancer screening strategies depends on the underlying natural course of lung cancer. We evaluate the expected stage distribution in the Mayo CT screening study under an existing simulation model of non-small cell lung cancer (NSCLC) progression calibrated to the Mayo lung project (MLP). Within a likelihood framework, we evaluate whether the probability of 5-year NSCLC survival conditional on tumor diameter at detection depends significantly on screening detection modality, namely chest X-ray and computed tomography. We describe a novel simulation framework in which tumor progression depends on cellular proliferation and mutation within a stem cell compartment of the tumor. We fit this model to randomized trial data from the MLP and produce estimates of the median radiologic size at the cure threshold. We examine the goodness of model fit with respect to radiologic tumor size and 5-year NSCLC survival among incident cancers in both the MLP and Mayo CT studies. An existing model of NSCLC progression under-predicts the number of advanced-stage incident NSCLCs among males in the Mayo CT study (p-value = 0.004). The probability of 5-year NSCLC survival conditional on tumor diameter depends significantly on detection modality (p-value = 0.0312). In our new model, selected solution sets having a median tumor diameter of 16.2ヨ22.1 mm at cure threshold among aggressive NSCLCs predict both MLP and Mayo CT outcomes. We conclude that the median lung tumor diameter at cure threshold among aggressive NSCLCs in male smokers may be small (<20 mm).en_US
dc.embargo.terms1 yearen_US
dc.identifier.citationGoldwasser, Deborah L. and Kimmel, Marek. "Small median tumor diameter at cure threshold (<20 mm) among aggressive non-small cell lung cancers in male smokers predicts both chest X-ray and CT screening outcomes in a novel simulation framework." <i>International Journal of Cancer,</i> 132, (2013) UICC: 189-197. http://dx.doi.org/10.1002/ijc.27599.
dc.identifier.doihttp://dx.doi.org/10.1002/ijc.27599en_US
dc.identifier.urihttps://hdl.handle.net/1911/69836
dc.language.isoengen_US
dc.publisherUICC
dc.rightsArticle is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
dc.titleSmall median tumor diameter at cure threshold (<20 mm) among aggressive non-small cell lung cancers in male smokers predicts both chest X-ray and CT screening outcomes in a novel simulation frameworken_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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