Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening
Background Worldwide, lung cancer (LC) is the second most frequent cancer and the leading cause of cancer related mortality. Low-dose CT (LDCT) screening reduced LC mortality by 20–24% in randomised trials of high-risk populations. A significant proportion of those screened have nodules detected tha...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e085118.full |
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| author | Matthew Callister Harry J de Koning Robert C Rintoul Carolyn Horst Arjun Nair John K Field Christine D Berg Samantha Quaife Rhian Gabe Stephen Duffy Sam Janes Philip AJ Crosbie Mark M Hammer Panos Alexandris Michael PA Davies |
| author_facet | Matthew Callister Harry J de Koning Robert C Rintoul Carolyn Horst Arjun Nair John K Field Christine D Berg Samantha Quaife Rhian Gabe Stephen Duffy Sam Janes Philip AJ Crosbie Mark M Hammer Panos Alexandris Michael PA Davies |
| author_sort | Matthew Callister |
| collection | DOAJ |
| description | Background Worldwide, lung cancer (LC) is the second most frequent cancer and the leading cause of cancer related mortality. Low-dose CT (LDCT) screening reduced LC mortality by 20–24% in randomised trials of high-risk populations. A significant proportion of those screened have nodules detected that are found to be benign. Consequently, many individuals receive extra imaging and/or unnecessary procedures, which can have a negative physical and psychological impact, as well as placing a financial burden on health systems. Therefore, there is a need to identify individuals who need no interval CT between screening rounds.Methods and analysis The aim of this study is to identify risk factors predictive of LC, which are known at the time of the scan, in patients with LDCT screen-detected lung nodules. The MEDLINE and EMBASE databases will be searched and articles that are on cohorts or mention cohorts of screenees with nodules will be identified. A data extraction framework will ensure consistent extraction across studies. Individual participant data (IPD) will be collected to perform a one-stage IPD meta-analysis using hierarchical univariate models. Clustering will be accounted for by having separate intercept terms for each cohort. Where IPD is not available, the effects of risk factors will be extracted from publications, if possible. Effects from IPD cohorts and aggregate data will be reported and compared. The PROBAST (Prediction model Risk Of Bias ASsessment Tool) will be used for assessment of quality of the studies.Ethics and dissemination Ethical approval was not required as this study is a secondary analysis. The results will be disseminated through publication in peer-reviewed journals and presentations at relevant conferences.PROSPERO registration number CRD42022309515 |
| format | Article |
| id | doaj-art-8ddf912b9e4941bdbd0057a1043712d3 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-8ddf912b9e4941bdbd0057a1043712d32025-01-27T08:50:12ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-085118Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screeningMatthew Callister0Harry J de Koning1Robert C Rintoul2Carolyn Horst3Arjun Nair4John K Field5Christine D Berg6Samantha Quaife7Rhian Gabe8Stephen Duffy9Sam Janes10Philip AJ Crosbie11Mark M Hammer12Panos Alexandris13Michael PA Davies14Leeds Teaching Hospitals NHS Trust, Leeds, UKPublic Health, Erasmus MC, Rotterdam, The Netherlands6 Department of Oncology, University of Cambridge, Cambridge, UKLungs for Living Research Centre, UCL Respiratory, University College London, London, UKUniversity College Hospital, London, UK1 Molecular and Clinical Cancer Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK4 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USAWolfson Institute of Population Health, Queen Mary University of London, London, UKCentre for Evaluation and Methods, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UKCRUK Department of EMS, Woflson Institute of Preventive Medicine, London, UKUniversity College London, London, UKDivision of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK1Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USACentre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UKDepartment of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UKBackground Worldwide, lung cancer (LC) is the second most frequent cancer and the leading cause of cancer related mortality. Low-dose CT (LDCT) screening reduced LC mortality by 20–24% in randomised trials of high-risk populations. A significant proportion of those screened have nodules detected that are found to be benign. Consequently, many individuals receive extra imaging and/or unnecessary procedures, which can have a negative physical and psychological impact, as well as placing a financial burden on health systems. Therefore, there is a need to identify individuals who need no interval CT between screening rounds.Methods and analysis The aim of this study is to identify risk factors predictive of LC, which are known at the time of the scan, in patients with LDCT screen-detected lung nodules. The MEDLINE and EMBASE databases will be searched and articles that are on cohorts or mention cohorts of screenees with nodules will be identified. A data extraction framework will ensure consistent extraction across studies. Individual participant data (IPD) will be collected to perform a one-stage IPD meta-analysis using hierarchical univariate models. Clustering will be accounted for by having separate intercept terms for each cohort. Where IPD is not available, the effects of risk factors will be extracted from publications, if possible. Effects from IPD cohorts and aggregate data will be reported and compared. The PROBAST (Prediction model Risk Of Bias ASsessment Tool) will be used for assessment of quality of the studies.Ethics and dissemination Ethical approval was not required as this study is a secondary analysis. The results will be disseminated through publication in peer-reviewed journals and presentations at relevant conferences.PROSPERO registration number CRD42022309515https://bmjopen.bmj.com/content/15/1/e085118.full |
| spellingShingle | Matthew Callister Harry J de Koning Robert C Rintoul Carolyn Horst Arjun Nair John K Field Christine D Berg Samantha Quaife Rhian Gabe Stephen Duffy Sam Janes Philip AJ Crosbie Mark M Hammer Panos Alexandris Michael PA Davies Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening BMJ Open |
| title | Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening |
| title_full | Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening |
| title_fullStr | Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening |
| title_full_unstemmed | Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening |
| title_short | Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening |
| title_sort | protocol for a systematic review and individual participant data meta analysis for risk factors for lung cancer in individuals with lung nodules identified by low dose ct screening |
| url | https://bmjopen.bmj.com/content/15/1/e085118.full |
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