A Makinson1, L Tron2,3, S Grabar4,5,6, B Milleron7,8, J Reynes1, V Le Moing1, D Morquin1, F Lert9, D Costagliola4, M Guiguet4. 1. Infectious and Tropical Diseases Department, UMI 233/INSERM U1175, Montpellier University Hospital, Montpellier, France. 2. University Hospital of Caen, Caen, France. 3. ANTICIPE' U1086 INSERM-UCN, François Baclesse Center, Caen, France. 4. INSERM, Institute of Epidemiology and Public Health Pierre Louis (IPLESP), Sorbonne Université, Paris, France. 5. Biostatistic and Epidemiology Unit, Cochin Hospital, Paris, France. 6. Paris-Descartes University, Paris, France. 7. French Cooperative Thoracic Intergroup (IFCT), Paris, France. 8. Public Hospitals of Paris (APHP), University Hospitals of Bichat and Tenon, Paris, France. 9. Department of Epidemiology of Occupational and Social Determinants of Health, Center for Research in Epidemiology and Population Health, INSERM, Villejuif, France.
Abstract
OBJECTIVES: In most lung screening programmes, only subjects ≥ 55 years old and smoking ≥ 30 pack-years are eligible to undergo chest low-dose computed tomography. Whether the same criteria should apply to people living with HIV (PLHIV) is uncertain, given the increased lung cancer risks associated with immunodeficiency and high rates of smoking. We assessed different outcomes obtained from simulating one round of lung cancer screening in PLHIV using different age and smoking thresholds for eligibility. METHODS: Data from the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS)-CO4 French Hospital Database on HIV (FHDH) cohort of PLHIV and a national representative survey of PLHIV in care in 2011 (the ANRS-VESPA2 [enquête sur les personnes atteintes] study) were used to estimate the maximum proportion of incident lung cancers occurring between 2012 and 2016 that would have potentially been detected by screening in 2011. Secondary outcomes were numbers of eligible subjects in the cohort and numbers of subjects needed to screen (NNS) to detect one lung cancer. RESULTS: Among 77819 PLHIV in 2011 (median age 46 years; 66% men), 285 subjects subsequently developed lung cancer. Adoption of the US Preventive Services Task Force (USPSTF) recommendations (55-80 years; ≥ 30 pack-years) would have detected 31% of lung cancers at most. Lowering the minimum age to 50 and 45 years would have detected 49% and 60% of cancers, respectively, but would have greatly increased the number of eligible subjects and the NNS to detect one case of lung cancer. CONCLUSIONS: Use of the USPSTF criteria would have detected only a minority of lung cancers in a large French cohort of PLHIV in 2011. Screening PLHIV at younger ages (45 or 50 years) and/or the use of lower smoking thresholds (20 pack-years) may be beneficial, despite the consequently higher numbers of eligible subjects and NNS to detect one case of lung cancer, and should be evaluated in future studies.
OBJECTIVES: In most lung screening programmes, only subjects ≥ 55 years old and smoking ≥ 30 pack-years are eligible to undergo chest low-dose computed tomography. Whether the same criteria should apply to people living with HIV (PLHIV) is uncertain, given the increased lung cancer risks associated with immunodeficiency and high rates of smoking. We assessed different outcomes obtained from simulating one round of lung cancer screening in PLHIV using different age and smoking thresholds for eligibility. METHODS: Data from the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS)-CO4 French Hospital Database on HIV (FHDH) cohort of PLHIV and a national representative survey of PLHIV in care in 2011 (the ANRS-VESPA2 [enquête sur les personnes atteintes] study) were used to estimate the maximum proportion of incident lung cancers occurring between 2012 and 2016 that would have potentially been detected by screening in 2011. Secondary outcomes were numbers of eligible subjects in the cohort and numbers of subjects needed to screen (NNS) to detect one lung cancer. RESULTS: Among 77819 PLHIV in 2011 (median age 46 years; 66% men), 285 subjects subsequently developed lung cancer. Adoption of the US Preventive Services Task Force (USPSTF) recommendations (55-80 years; ≥ 30 pack-years) would have detected 31% of lung cancers at most. Lowering the minimum age to 50 and 45 years would have detected 49% and 60% of cancers, respectively, but would have greatly increased the number of eligible subjects and the NNS to detect one case of lung cancer. CONCLUSIONS: Use of the USPSTF criteria would have detected only a minority of lung cancers in a large French cohort of PLHIV in 2011. Screening PLHIV at younger ages (45 or 50 years) and/or the use of lower smoking thresholds (20 pack-years) may be beneficial, despite the consequently higher numbers of eligible subjects and NNS to detect one case of lung cancer, and should be evaluated in future studies.
Authors: Subhashini A Sellers; Andrew Edmonds; Catalina Ramirez; Sushma K Cribbs; Igho Ofotokun; Laurence Huang; Alison Morris; Meredith C Mccormack; Ken M Kunisaki; Gypsyamber D'souza; M Patricia Rivera; M Bradley Drummond; Adaora A Adimora Journal: J Acquir Immune Defic Syndr Date: 2022-06-01 Impact factor: 3.771
Authors: M Patricia Rivera; Hormuzd A Katki; Nichole T Tanner; Matthew Triplette; Lori C Sakoda; Renda Soylemez Wiener; Roberto Cardarelli; Lisa Carter-Harris; Kristina Crothers; Joelle T Fathi; Marvella E Ford; Robert Smith; Robert A Winn; Juan P Wisnivesky; Louise M Henderson; Melinda C Aldrich Journal: Am J Respir Crit Care Med Date: 2020-10-01 Impact factor: 21.405