Potential Health Effects of a Blood-Based Genomic Test Used to Prescreen Individuals Eligible for Lung Cancer Screening in the U.S.
Author(s)
Bach P1, Ortendahl J2, Trivedi N1, Cisar C3
1Delfi Diagnostics, Baltimore, MD, USA, 2Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA, 3Delfi Diagnostics, Salt Lake City, UT, USA
Presentation Documents
OBJECTIVES:
Annual screening for lung cancer by low-dose computed tomography (LDCT) reduces mortality. But sparse adoption has limited population benefits in both the US and worldwide. We examined a model of the clinical effects of introducing an easily accessible blood-based genomic test for use as a “PRESCREEN” that would support more rapid and refined uptake of LDCT screening within the eligible population in the US.METHODS:
Methods: Multiple 2-million-subject Monte Carlo simulations compared a 5-year growth rate of LDCT screening in the screening eligible US population (beginning at 6% adoption, rising to 7% by year 5); to a scenario where the PRESCREEN saw more rapid uptake (same baseline utilization, rising to 14% by year 5). Model assumptions were derived from published clinical trials of LDCT, population smoking and age distribution from surveys. Within the PRESCREEN group, we compared scenarios where it had considerable vs more modest influence on subsequent ordering of an LDCT. The PRESCREEN was set to 83% sensitivity and 50% specificity for lung cancer.RESULTS:
The model results suggested that whether the PRESCREEN had considerable impact (95% receiving LDCT following positive result, 10% following negative result) or modest impact (75% and 25%, respectively), clinical outcomes were meaningfully improved in the simulated population. Respectively, screened detected cancers rose by 10% and 8%, stage 1 diagnoses increased by 2.8% and 2.7%. Stage IV diagnoses decreased by 1.9% in both. The true positive to false positive ratio for LDCT improved by 9% and 6%.CONCLUSIONS:
A simulation model where a PRESCREEN is used to improve uptake and efficiency of LDCT screening suggests substantial population level health gains across a range of assumptions regarding its impact on subsequent LDCT utilization.Conference/Value in Health Info
2022-11, ISPOR Europe 2022, Vienna, Austria
Value in Health, Volume 25, Issue 12S (December 2022)
Code
EPH125
Topic
Epidemiology & Public Health, Medical Technologies, Methodological & Statistical Research, Study Approaches
Topic Subcategory
Decision Modeling & Simulation, Diagnostics & Imaging, Public Health
Disease
STA: Medical Devices