Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/μl.
Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/μl.
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DOI：
10.1097/qad.0000000000001818
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发表时间：
2018-06-19
期刊：
影响因子：
--
通讯作者：
Crothers K
中科院分区：
文献类型：
--
作者：
Kong CY;Sigel K;Criss SD;Sheehan DF;Triplette M;Silverberg MJ;Henschke CI;Justice A;Braithwaite RS;Wisnivesky J;Crothers K
补充数字内容可在文本肺癌是艾滋病毒感染者中非艾滋病定义癌症死亡的主要原因。虽然低剂量计算机断层扫描（LDCT）肺癌筛查得到了多个国家组织的认可，但艾滋病毒感染者是否会与未感染者一样从肺癌筛查中获益尚不清楚。我们的目标是确定艾滋病毒感染者中肺癌筛查的益处和危害。我们修改了现有的模拟模型，肺癌政策模型，艾滋病毒感染者。退伍军人老龄化队列研究，凯泽永久北方加州艾滋病毒队列，和医学文献。·感染艾滋病毒的吸烟者和前吸烟者。：终身。：人口。从45岁、50岁或55岁到72岁或77岁每年进行LDCT筛查。评估的益处包括肺癌死亡率降低和生命年增加;评估的危害包括LDCT检查次数、假阳性结果和过度诊断病例。对于CD4+细胞计数至少500个细胞/μ l且100%抗逆转录病毒治疗依从性的HIV感染患者，使用医疗保险和医疗补助服务中心标准（年龄55 - 77岁，吸烟30包年，目前吸烟者或在筛查后15年内戒烟）进行筛查将使肺癌死亡率降低18.9%，与未感染个体的死亡率降低相似。采用较低的筛查年龄和/或包年标准的替代筛查策略可降低死亡率，但需要更多的LDCT检查。策略假设100%的筛查依从性。肺癌筛查可降低CD4+细胞计数至少为500个细胞/μ l的HIV感染患者的死亡率，并有许多有效的合格策略，包括目前的医疗保险和医疗补助服务中心标准。
Supplemental Digital Content is available in the text 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. We modified an existing simulation model, the Lung Cancer Policy Model, for HIV-infected patients. Veterans Aging Cohort Study, Kaiser Permanente Northern California HIV Cohort, and medical literature. : HIV-infected current and former smokers. : Lifetime. : Population. Annual LDCT screening from ages 45, 50, or 55 until ages 72 or 77 years. Benefits assessed included lung cancer mortality reduction and life-years gained; harms assessed included numbers of LDCT examinations, false-positive results, and overdiagnosed cases. 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. Strategies assumed 100% screening adherence. 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.
影响因子：
3.7
作者：
Khademi A;Braithwaite RS;Saure D;Schaefer AJ;Nucifora K;Roberts MS
通讯作者：
Roberts MS
DOI：
10.1111/j.1524-4733.2010.00714.x
发表时间：
2010-08
期刊：
Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
影响因子：
--
作者：
Braithwaite RS;Fiellin DA;Nucifora K;Bryant K;Roberts M;Kim N;Justice AC
通讯作者：
Justice AC