{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:06:46Z","timestamp":1792112806209,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In 2021, the US Preventive Services Task Force expanded its lung screening recommendation to include persons aged 50\u201380 years who had ever smoked and had at least 20 pack\u2010years of exposure and less than 15 years since quitting (YSQ). However, studies have suggested that screening persons who formerly smoked with longer YSQ could be beneficial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors used two validated lung cancer models to assess the benefits and harms of screening using various YSQ thresholds (10, 15, 20, 25, 30, and no YSQ) and the age at which screening was stopped. The impact of enforcing the YSQ criterion only at entry, but not at exit, also was evaluated. Outcomes included the number of screens, the percentage ever screened, screening benefits (lung cancer deaths averted, life\u2010years gained), and harms (false\u2010positive tests, overdiagnosed cases, radiation\u2010induced lung cancer deaths). Sensitivity analyses were conducted to evaluate the effect of restricting screening to those who had at least 5 years of life expectancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>As the YSQ criterion was relaxed, the number of screens and the benefits and harms of screening increased. Raising the age at which to stop screening age resulted in additional benefits but with more overdiagnosis, as expected, because screening among those older than 80 years increased. Limiting screening to those who had at least 5 years of life expectancy would maintain most of the benefits while considerably reducing the harms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Expanding screening to persons who formerly smoked and have greater than 15 YSQ would result in considerable increases in deaths averted and life\u2010years gained. Although additional harms would occur, these could be moderated by ensuring that screening is restricted to only those with reasonable life expectancy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34925","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T10:01:21Z","timestamp":1698832881000},"page":"244-255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Assessing the impact of increasing lung screening eligibility by relaxing the maximum years\u2010since\u2010quit threshold: A\u00a0simulation modeling study"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1076-5037","authenticated-orcid":false,"given":"Rafael","family":"Meza","sequence":"first","affiliation":[{"name":"Department of Integrative Oncology British Columbia Cancer Research Institute  Vancouver British Columbia Canada"},{"name":"Department of Epidemiology University of Michigan  Ann Arbor Michigan USA"},{"name":"School of Population and Public Health University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pianpian","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1451-0557","authenticated-orcid":false,"given":"Koen","family":"de Nijs","sequence":"additional","affiliation":[{"name":"Department of Public Health Erasmus MC\u2013University Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihyoun","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3344-2238","authenticated-orcid":false,"given":"Robert A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Early Cancer Detection Science Department American Cancer Society  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"ten Haaf","sequence":"additional","affiliation":[{"name":"Department of Public Health Erasmus MC\u2013University Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"de Koning","sequence":"additional","affiliation":[{"name":"Department of Public Health Erasmus MC\u2013University Medical Center  Rotterdam The 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