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A Canadian peer-reviewed journal of population health and health services research
Performance of the Cancer Risk Management Model Lung Cancer Screening Module
by William M. Flanagan, William K. Evans, Natalie R. Fitzgerald, John R. Goffin, Anthony B. Miller and Michael C. Wolfson
The National Lung Screening Trial (NLST) was conducted in the United States from August 2002 through April 2004 to determine if low-dose computed tomography (LDCT) screening could reduce lung cancer mortality. The NLST, which involved more than 53,000 participants, showed that three annual scans of a high-risk population resulted in a 20% reduction of lung cancer mortality after about six years of follow-up. Smaller European trials with somewhat different screening protocols and at-risk populations found either some evidence of lower mortality or no benefit. The U.S. Preventive Services Task Force rated the quality of these European trials as fair or less, but rated the NLST as a large, good-quality trial, and gave a grade B recommendation for annual LDCT screening of people aged 55 to 80 with a 30-pack-year smoking history who currently smoke or who quit within the past 15 years. However, the optimal "at-risk� population for screening is not known, nor is the optimal frequency or duration of screening. As well, the cost-effectiveness of LDCT and smoking cessation has been projected for a U.S. population, but not for Canada.
Assessment of the quality of the childhood physical abuse measure in the National Population Health Survey
by Margot Shields, Wendy Hovdestad and Lil Tonmyr
Numerous studies have documented associations between childhood physical abuse and subsequent mental and physical disorders. The measure of abuse in these analyses is typically based on retrospective reports from adults. In order to best interpret studies that link childhood physical abuse to health problems in later life, it is important to understand the validity and reliability of such measures.
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