Sojourn time and lead time projection in lung cancer screening.
Sojourn time and lead time projection in lung cancer screening.
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DOI：
10.1016/j.lungcan.2010.10.010
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发表时间：
2011-06
期刊：
影响因子：
--
通讯作者：
Rosner GL
中科院分区：
文献类型：
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作者：
Wu D;Erwin D;Rosner GL
我们使用马约肺项目的数据研究了男性重度吸烟者肺癌筛查的敏感性、转移概率和逗留时间。我们还估计了前置时间分布，其属性，以及定期胸部X光检查肺癌检测的预计效果。我们应用Wu等人开发的统计方法，使用马约肺项目（MLP）数据，对男性重度吸烟者在定期筛查项目中的筛查试验敏感性、从无病状态到临床前状态的年龄依赖性转移概率以及逗留时间分布进行贝叶斯推断。然后，我们应用Wu等人开发的统计方法。使用来自MLP数据的贝叶斯后验样本来推断前置时间，即通过筛查男性重度吸烟者而提前的诊断时间。提前期分布为零点质量和分段连续分布的混合物，其对应于无早期检测的概率和早期诊断时间的概率分布。我们目前的估计，这两个措施，男性重度吸烟者的模拟。后验灵敏度几乎是对称的，后验均值为0.89，后验中位数为0.91; 95%最高后验密度（HPD）区间为（0.72，0.98）。后验平均逗留时间为2.24年，男性重度吸烟者的后验中位数为2.20年。平均逗留时间的95%HPD间隔为（1.57，3.35）年。与年龄相关的转移概率不是年龄的单调函数;它在68岁时有一个最大值。平均前置时间随着筛选时间间隔的缩短而增加。前置时间的标准误差也随着筛选时间间隔的减少而增加。虽然男性重度吸烟者的平均逗留时间比预期的要长，但提前期的预测估计要短得多。这可能为政策制定者提供有关胸部X线和痰细胞学检查在肺癌早期发现中的有效性的重要信息。出版社：Elsevier爱尔兰Ltd.
We investigate screening sensitivity, transition probability and sojourn time in lung cancer screening for male heavy smokers using the Mayo Lung Project data. We also estimate the lead time distribution, its property, and the projected effect of taking regular chest X-rays for lung cancer detection. We apply the statistical method developed by Wu et al. using the Mayo Lung Project (MLP) data, to make Bayesian inference for the screening test sensitivity, the age-dependent transition probability from disease-free to preclinical state, and the sojourn time distribution, for male heavy smokers in a periodic screening program. We then apply the statistical method developed by Wu et al. using the Bayesian posterior samples from the MLP data to make inference for the lead time, the time of diagnosis advanced by screening for male heavy smokers. The lead time is distributed as a mixture of a point mass at zero and a piecewise continuous distribution, which corresponds to the probability of no-early-detection, and the probability distribution of the early diagnosis time. We present estimates of these two measures for male heavy smokers by simulations. The posterior sensitivity is almost symmetric, with posterior mean 0.89, and posterior median 0.91; the 95% highest posterior density (HPD) interval is (0.72, 0.98). The posterior mean sojourn time is 2.24 years, with a posterior median of 2.20 years for male heavy smokers. The 95% HPD interval for the mean sojourn time is (1.57, 3.35) years. The age-dependent transition probability is not a monotone function of age; it has a single maximum at age 68. The mean lead time increases as the screening time interval decreases. The standard error of the lead time also increases as the screening time interval decreases. Although the mean sojourn time for male heavy smokers is longer than expected, the predictive estimation of the lead time is much shorter. This may provide policy makers important information on the effectiveness of the chest X-rays and sputum cytology in lung cancer early detection. Published by Elsevier Ireland Ltd.