Lung-RADS versus PanCan screening for patients at high risk of lung cancer

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Project Status:
Completed
Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:
RC1400-000

Question

  1. What is the comparative diagnostic accuracy of the Lung Imaging Reporting and Data System versus the Pan-Canadian Early Detection of Lung Cancer nodule risk calculation for the identification of malignant lung nodules in patients at high risk of lung cancer undergoing screening with low-dose CT?
  2. What is the comparative clinical utility of the Lung Imaging Reporting and Data System versus the Pan-Canadian Early Detection of Lung Cancer nodule risk calculation for the identification of malignant lung nodules in patients at high risk of lung cancer undergoing screening with low-dose CT?
  3. What is the comparative cost-effectiveness of the Lung Imaging Reporting and Data System versus the Pan-Canadian Early Detection of Lung Cancer nodule risk calculation for the identification of malignant lung nodules in patients at high risk of lung cancer undergoing screening with low-dose CT?4. What are the evidence-based guidelines describing use of the Lung Imaging Reporting and Data System and/or the Pan-Canadian Early Detection of Lung Cancer nodule risk calculation for the identification of malignant lung nodules in patients at high risk of lung cancer undergoing screening with low-dose CT?

Key Message

Evidence of variable quality from 6 diagnostic test accuracy studies indicates that the Pan-Canadian Early Detection of Lung Cancer (PanCan) model may perform better at determining which lung nodules identified by low-dose CT are cancerous compared to the Lung Imaging Reporting and Data System. However, evidence from 3 other studies, also of variable quality, suggests that the risk calculators have similar diagnostic test accuracy.

No studies were identified that compared the clinical utility of PanCan versus the Lung Imaging Reporting and Data System.

Results from 2 economic evaluations were inconsistent about the cost-effectiveness of the 2 lung cancer risk models. However, each study applied the models to different types of lung nodules.

One evidence-based guideline recommended that PanCan be used in the UK for initial risk assessment and for the management of lung nodules.