Estimating stage-specific sensitivity for cancer screening tests

التفاصيل البيبلوغرافية
العنوان: Estimating stage-specific sensitivity for cancer screening tests
المؤلفون: Paul Pinsky, Jane Lange, Ruth Etzioni
المصدر: Journal of Medical Screening. 30:69-73
بيانات النشر: SAGE Publications, 2023.
سنة النشر: 2023
مصطلحات موضوعية: Health Policy, Public Health, Environmental and Occupational Health
الوصف: Objectives When evaluating potential new cancer screening modalities, estimating sensitivity, especially for early-stage cases, is critical. There are methods to approximate stage-specific sensitivity in asymptomatic populations, both in the prospective (active screening) and retrospective (stored specimens) scenarios. We explored their validity via a simulation study. Methods We fit natural history models to lung and ovarian cancer screening data that permitted estimation of stage-specific (early/late) true sensitivity, defined as the probability subjects screened in the given stage had positive tests. We then ran simulations, using the fitted models, of the prospective and retrospective scenarios. Prospective sensitivity by stage was estimated as screen-detected divided by screen-plus interval-detected cancers, where stage is defined as stage at detection. Retrospective sensitivity by stage was estimated based on cancers detected within specified windows before clinical diagnosis with stage defined as stage at clinical diagnosis. Results Stage-specific true sensitivities estimated by the lung cancer natural history model were 47% (early) and 63% (late). Simulation results for the prospective setting gave estimated sensitivities of 81% (early) versus 62% (late). In the retrospective scenario, early/late sensitivity estimates were 35%/57% (1-year window) and 27%/49% (2-year window). In the prospective scenario, most subjects with negative early-stage screens presented as other than early-stage interval cases. Results were similar for ovarian cancer, with estimated prospective sensitivity much greater than true sensitivity for early stage, 84% versus 25%. Conclusions Existing methods for approximating stage-specific sensitivity in both prospective and retrospective scenarios are unsatisfactory; improvements are needed before they can be considered to be reliable.
تدمد: 1475-5793
0969-1413
DOI: 10.1177/09691413231154801
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::e42c7672d5725d90b3e7f988adc0e4f8
https://doi.org/10.1177/09691413231154801
Rights: CLOSED
رقم الانضمام: edsair.doi...........e42c7672d5725d90b3e7f988adc0e4f8
قاعدة البيانات: OpenAIRE
الوصف
تدمد:14755793
09691413
DOI:10.1177/09691413231154801