{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:13:10Z","timestamp":1793725990534,"version":"4.6.1"},"reference-count":121,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Med Screen"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Comorbidity is associated with adverse outcomes for all lung cancer patients, but its burden is less understood in the context of screening. This review synthesises the prevalence of comorbidities among lung cancer screening (LCS) candidates and summarises the clinical recommendations for screening comorbid individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched MEDLINE, EMBASE, EBM Reviews, and CINAHL databases from January 1990 to February 2021. We included LCS studies that reported a prevalence of comorbidity, as a prevalence of a particular condition, or as a summary score. We also summarised LCS clinical guidelines that addressed comorbidity or frailty for LCS as a secondary objective for this review. Meta-analysis was used with inverse-variance weights obtained from a random-effects model to estimate the prevalence of selected comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 69 studies in the review; seven reported comorbidity summary scores, two reported performance status, 48 reported individual comorbidities, and 12 were clinical guideline papers. The meta-analysis of individual comorbidities resulted in an estimated prevalence of 35.2% for hypertension, 23.5% for history of chronic obstructive pulmonary disease (COPD) (10.7% for severe COPD), 16.6% for ischaemic heart disease (IHD), 13.1% for peripheral vascular disease (PVD), 12.9% for asthma, 12.5% for diabetes, 4.5% for bronchiectasis, 2.2% for stroke, and 0.5% for pulmonary fibrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Comorbidities were highly prevalent in LCS populations and likely to be more prevalent than in other cancer screening programmes. Further research on the burden of comorbid disease and its impact on screening uptake and outcomes is needed. Identifying individuals with frailty and comorbidities who might not benefit from screening should become a priority in LCS research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09691413221117685","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T04:02:16Z","timestamp":1660017736000},"page":"3-13","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["The prevalence of comorbidity in the lung cancer screening population: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7893-0123","authenticated-orcid":false,"given":"Anas","family":"Almatrafi","sequence":"first","affiliation":[{"name":"Leeds Institute of Health Sciences, University of Leeds, Leeds, UK"},{"name":"Department of Epidemiology, Umm Al-Qura University, Makkah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Thomas","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Callister","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Leeds Teaching Hospitals, St James's University Hospital, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhian","family":"Gabe","sequence":"additional","affiliation":[{"name":"Center for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8287-9351","authenticated-orcid":false,"given":"Rebecca J","family":"Beeken","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, University of Leeds, Leeds, UK"},{"name":"Department of Behavioural Science and Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Neal","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, University of Leeds, Leeds, UK"},{"name":"College of Medicine and Health, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"key":"bibr1-09691413221117685","volume-title":"Global cancer observatory: cancer today","author":"Ferlay J","year":"2020"},{"key":"bibr2-09691413221117685","unstructured":"Arnold M, Rutherford M, Lam F, et al. ICBP SURVMARK-2 online tool: International Cancer Survival Benchmarking, http:\/\/gco.iarc.fr\/survival\/survmark (2019, accessed 15\/06 2021)."},{"key":"bibr3-09691413221117685","unstructured":"SEER*Explorer: An interactive website for SEER cancer statistics, https:\/\/seer.cancer.gov\/explorer\/ (2021, accessed 15\/06 2021)."},{"key":"bibr4-09691413221117685","unstructured":"Cancer Research UK. Lung cancer statistics, https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/lung-cancer (2021, accessed 15\/06 2021)."},{"key":"bibr5-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1102873"},{"key":"bibr6-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911793"},{"key":"bibr7-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.07.030"},{"key":"bibr8-09691413221117685","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13236110"},{"key":"bibr9-09691413221117685","doi-asserted-by":"crossref","unstructured":"Liang D, Shi J, Li D, et al. Participation and Yield of a Lung Cancer Screening Program in Hebei, China. 2022; 11. Original Research. https:\/\/doi.org\/10.3389\/fonc.2021.795528.","DOI":"10.3389\/fonc.2021.795528"},{"key":"bibr10-09691413221117685","first-page":"1076","volume":"41","author":"Guo LW","year":"2020","journal-title":"Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi"},{"key":"bibr11-09691413221117685","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr.2020.03.16"},{"key":"bibr12-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2019.05.026"},{"key":"bibr13-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2017-211377"},{"key":"bibr14-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70336-X"},{"key":"bibr15-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201805-0986ST"},{"key":"bibr16-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2018.03.003"},{"key":"bibr17-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"bibr18-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"bibr19-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"bibr20-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"bibr21-09691413221117685","unstructured":"Wells G, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. In: 2014."},{"key":"bibr22-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-154"},{"key":"bibr23-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980430)17:8<857::AID-SIM777>3.0.CO;2-E"},{"key":"bibr24-09691413221117685","unstructured":"StataCorp. Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC., 2019."},{"key":"bibr25-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201806-389RL"},{"key":"bibr26-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2014.11.003"},{"key":"bibr27-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3338-9"},{"key":"bibr28-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05539-w"},{"key":"bibr29-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2018.12.003"},{"key":"bibr30-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.08.2187"},{"key":"bibr31-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju084"},{"key":"bibr32-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.05.060"},{"key":"bibr33-09691413221117685","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2018.0020"},{"key":"bibr34-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2350"},{"key":"bibr35-09691413221117685","doi-asserted-by":"publisher","DOI":"10.5603\/ARM.2018.0009"},{"key":"bibr36-09691413221117685","first-page":"54","volume":"1","author":"Gupta S","year":"2017","journal-title":"Can J Respir Crit Care Sleep Med"},{"key":"bibr37-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.1117"},{"key":"bibr38-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.12287"},{"key":"bibr39-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000060"},{"key":"bibr40-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwk075"},{"key":"bibr41-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-214703"},{"key":"bibr42-09691413221117685","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-962596\/v1"},{"key":"bibr43-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-219"},{"key":"bibr44-09691413221117685","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S250418"},{"key":"bibr45-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-015-1346-2"},{"key":"bibr46-09691413221117685","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S176923"},{"key":"bibr47-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-021-01408-2"},{"key":"bibr48-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2019-213584"},{"key":"bibr49-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211776"},{"key":"bibr50-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30081-3"},{"key":"bibr51-09691413221117685","first-page":"233","volume":"6","author":"Regan EA","year":"2019","journal-title":"Chronic Obstr Pulm Dis"},{"key":"bibr52-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205273"},{"key":"bibr53-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jet057"},{"key":"bibr54-09691413221117685","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2010.510160"},{"key":"bibr55-09691413221117685","first-page":"279","volume":"132","author":"Hopkins RJ","year":"2017","journal-title":"Respir Med"},{"key":"bibr56-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021322"},{"key":"bibr57-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00621-2017"},{"key":"bibr58-09691413221117685","unstructured":"American Lung Assocation. COPD Prevalence-Chronic Bronchitis, https:\/\/www.lung.org\/research\/trends-in-lung-disease\/copd-trends-brief\/copd-prevalence (2018, accessed 12\/10\/2021 2021)."},{"key":"bibr59-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2011.12.002"},{"key":"bibr60-09691413221117685","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss7005a1"},{"key":"bibr61-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02130-2018"},{"key":"bibr62-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.03.015"},{"key":"bibr63-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2007.05.009"},{"key":"bibr64-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2003.008821"},{"key":"bibr65-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2012.05.005"},{"key":"bibr66-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-006-0532-7"},{"key":"bibr67-09691413221117685","doi-asserted-by":"crossref","first-page":"e0231204","DOI":"10.1371\/journal.pone.0231204","volume":"15","author":"Abad MSC","year":"2020","journal-title":"PLoS ONE"},{"key":"bibr68-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000757"},{"key":"bibr69-09691413221117685","unstructured":"British Heart Foundation. Heart and Circulatory Disease Statistics https:\/\/www.bhf.org.uk\/what-we-do\/our-research\/heart-statistics\/heart-statistics-publications\/cardiovascular-disease-statistics-2021 (2021, accessed 10\/12 2021)."},{"key":"bibr70-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2001.10113.x"},{"key":"bibr71-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu540"},{"key":"bibr72-09691413221117685","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S201062"},{"key":"bibr73-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2017.09.002"},{"key":"bibr74-09691413221117685","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S201873"},{"key":"bibr75-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest2022.02.027"},{"key":"bibr76-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-214626"},{"key":"bibr77-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2248"},{"key":"bibr78-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200803-435OC"},{"key":"bibr79-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq434"},{"key":"bibr80-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-8266-z"},{"key":"bibr81-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-020-01344-y"},{"key":"bibr82-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07049-4"},{"key":"bibr83-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12180"},{"key":"bibr84-09691413221117685","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.5577"},{"key":"bibr85-09691413221117685","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/S0735-1097(17)34946-X","volume":"69","author":"Leigh J","year":"2017","journal-title":"JACC: Cardiovasc Imaging"},{"key":"bibr86-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2015.01.014"},{"key":"bibr87-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12179"},{"key":"bibr88-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2018-105431"},{"key":"bibr89-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-10-0151"},{"key":"bibr90-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/7142568"},{"key":"bibr91-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2006.00827.x"},{"key":"bibr92-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.19039"},{"key":"bibr93-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2018-212812"},{"key":"bibr94-09691413221117685","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.15.15537"},{"key":"bibr95-09691413221117685","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1556\/650.2018.31167","volume":"159","author":"Anna KF","year":"2018","journal-title":"Orv Hetil"},{"key":"bibr96-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2019.06.010"},{"key":"bibr97-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195441"},{"key":"bibr98-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201410-1848OC"},{"key":"bibr99-09691413221117685","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2010.69.3.177"},{"key":"bibr100-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2017.12.023"},{"key":"bibr101-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2007.08.040"},{"key":"bibr102-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2019.11.016"},{"key":"bibr103-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2014.09.019"},{"key":"bibr104-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckz052"},{"key":"bibr105-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00049909"},{"key":"bibr106-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkaa053"},{"key":"bibr107-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2019.01.031"},{"key":"bibr108-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30597-1"},{"key":"bibr109-09691413221117685","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.18853"},{"key":"bibr110-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1159\/000050526"},{"key":"bibr111-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201911-857OC"},{"key":"bibr112-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201609-741OC"},{"key":"bibr113-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11110364"},{"key":"bibr114-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201505-1040OC"},{"key":"bibr115-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2018.10.020"},{"key":"bibr116-09691413221117685","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S62053"},{"key":"bibr117-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2018.08.006"},{"key":"bibr118-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0042227"},{"key":"bibr119-09691413221117685","doi-asserted-by":"crossref","first-page":"607","DOI":"10.20452\/pamw.3029","volume":"125","author":"Adamek M","year":"2015","journal-title":"Pol Arch Med Wewn"},{"key":"bibr120-09691413221117685","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.01.016"},{"key":"bibr121-09691413221117685","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12061672"}],"container-title":["Journal of Medical Screening"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09691413221117685","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09691413221117685","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09691413221117685","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:25:32Z","timestamp":1777677932000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09691413221117685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,9]]},"references-count":121,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1177\/09691413221117685"],"URL":"https:\/\/doi.org\/10.1177\/09691413221117685","relation":{},"ISSN":["0969-1413","1475-5793"],"issn-type":[{"value":"0969-1413","type":"print"},{"value":"1475-5793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,9]]}}}