该报告量化了戒烟年数和伴随的衰老对肺癌风险的抵消影响，特别是超过 15 年戒烟年数，此时美国预防服务工作组 (USPSTF) 建议减少肺癌筛查。Cox 模型用于估计绝对肺癌风险曾经吸烟的前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验 (PLCO) 和国家肺部筛查试验 (NLST) 参与者的癌症风险。在 2015-2018 年美国全国健康访谈调查 (NHIS) 中，对曾经吸烟的 50 岁至 80 岁个体进行筛查，预测了肺癌的绝对风险和可延长的寿命。将 USPSTF 建议放宽至 20/25/30 戒烟年与扩大 USPSTF 标准，根据筛查寿命年 (LYFS-CT) 预测模型，对筛查后预期寿命增加超过 16.2 天的个体进行比较。 绝对肺PLCO 戒烟年龄超过 15 岁的个体的癌症风险每年增加 8.7%（95% CI，7.7%-9.7%；p < .001），NHIS 和 NLST 的结果相似。例如，65 岁戒烟 15 年的人的平均 5 年肺癌风险 = 1.47%（95% CI，1.35%-1.59%），而那些戒烟 15 年的人的平均 5 年肺癌风险为 1.76%（95% CI，1.62%-1.90%） 70 岁，在 PLCO 工作了 20 年。取消戒烟年标准将使符合资格的人数增加 490 万人，并将可预防的肺癌死亡比例（敏感性）从 63.7% 提高到 74.2%。另外，使用 LYFS-CT 进行增强将使 170 万人符合资格，同时将肺癌死亡敏感性提高到 74.0%。由于年龄增长，绝对肺癌风险会在戒烟 15 年之后增加，这并不支持豁免筛查或减少筛查一旦启动。与放宽 USPSTF 戒烟年标准相比，使用 LYFS-CT 进行增强治疗可以以显着更高的效率预防大多数死亡，同时还可以预防目前低强度或长时间吸烟的个体的死亡。2023 年发表。本文来自美国在美国，政府工作属于公共领域。 《癌症》由 Wiley periodicals LLC 代表美国癌症协会出版。

This report quantifies counteracting effects of quit-years and concomitant aging on lung cancer risk, especially on exceeding 15 quit-years, when the US Preventive Services Task Force (USPSTF) recommends curtailing lung-cancer screening.Cox models were fitted to estimate absolute lung cancer risk among Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) and National Lung Screening Trial (NLST) participants who ever smoked. Absolute lung cancer risk and gainable years of life from screening for individuals aged 50 to 80 in the US-representative National Health Interview Survey (NHIS) 2015-2018 who ever smoked were projected. Relaxing USPSTF recommendations to 20/25/30 quit-years versus augmenting USPSTF criteria with individuals whose estimated gain in life expectancy from screening exceeded 16.2 days according to the Life Years From Screening-CT (LYFS-CT) prediction model was compared.Absolute lung cancer risk increased by 8.7%/year (95% CI, 7.7%-9.7%; p < .001) as individuals aged beyond 15 quit-years in the PLCO, with similar results in NHIS and NLST. For example, mean 5-year lung cancer risk for those aged 65 years with 15 quit-years = 1.47% (95% CI, 1.35%-1.59%) versus 1.76% (95% CI, 1.62%-1.90%) for those aged 70 years with 20 quit-years in the PLCO. Removing the quit-year criterion would make 4.9 million more people eligible and increase the proportion of preventable lung cancer deaths prevented (sensitivity) from 63.7% to 74.2%. Alternatively, augmentation using LYFS-CT would make 1.7 million more people eligible while increasing the lung cancer death sensitivity to 74.0%.Because of aging, absolute lung cancer risk increases beyond 15 quit-years, which does not support exemption from screening or curtailing screening once it has been initiated. Compared with relaxing the USPSTF quit-year criterion, augmentation using LYFS-CT could prevent most of the deaths at substantially superior efficiency, while also preventing deaths among individuals who currently smoke with low intensity or long duration.Published 2023. This article is a U.S. Government work and is in the public domain in the USA. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.