LDCT (low-dose computed tomography) screening is an important method for the early detection of lung cancer. Because of harm due to radiation and cost concerns, LDCT screening for lung cancer is recommended for people with elevated risk. Several elevated risk criteria have been proposed. The US Preventive Services Taskforce (USPSTF) suggested in 2013 that people aged 55—80, having a smoking history of 30 pack-years or more, and having smoked in the past 15 years are recommended to undergo LDCT screening once per year. In 2017, the National Comprehensive Cancer Network (NCCN) of the US recommended that people aged 50+ have a smoking history of 20 pack-years or more and a lung cancer risk higher than 1.3% according to the PLCO 2012 model (PLCOM2012), which estimates the probability of lung cancer diagnosis in the upcoming 6 years among ever-smokers.
PLCOM2012 was developed in the USA and subsequently validated in Canada, Germany, Australia, England, Poland, and Brazil. It is regarded as a good model for identifying high-risk ever-smokers for LDCT screening. Using several Taiwan health databases and lung cancer epidemiology studies, we adapted it for Taiwan use after recalibration and validation. It is a selected highlight in Cancer Epidemiology, Biomarker & Prevention 2022 (31:2208—18) .
The lung cancer risk calculator PLCOT-1 provided on this website is based on the abovementioned paper. An ever-smoking individual aged 50—74 without any cancer diagnosis can obtain his/her probability of lung cancer in the next 6 years by providing the following information: age, BMI (body mass index), COPD history, education level, family history of lung cancer, and smoking information (years smoked, average number of cigarettes smoked per day, smoking quit time).
We suggest that ever-smokers present the estimates from PLCOT-1 to his/her physicians for counseling.
1. Li-Hsin Chien, Tzu-Yu Chen, Chung-Hsing Chen, Kuan-Yu Chen, Chin-Fu Hsiao, Gee-Chen Chang, Ying-Huang Tsai, Wu-Chou Su, Ming-Shyan Huang, Yuh-Min Chen, Chih-Yi Chen, Sheng-Kai Liang, Chung-Yu Chen, Chih-Liang Wang, Hsiao-Han Hung, Hsin-Fang Jiang, Jia-Wei Hu, Nathaniel Rothman, Qing Lan, Tsang-Wu Liu, Chien-Jen Chen, Pan-Chyr Yang, I-Shou Chang*, Chao A. Hsiung*. Recalibrating risk prediction models by synthesizing data sources: adapting the lung cancer PLCO model for Taiwan, Cancer Epidemiol Biomarkers Prev. 2022;31(12):2208 - 2218. https://doi.org/10.1158/1055-9965.EPI-22-0281