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Abstract:
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Estimation of the three key parameters (sensitivity, sojourn time, time in disease-free state) in cancer screening is critical, since all other terms (lead-time, over diagnosis, etc.) are functions of the three. Different functions to link one’s screening sensitivity with the ratio of one’s time in the preclinical state to the sojourn time are explored using likelihood method. The intuition comes from the fact that the sensitivity depends on how long one has entered the preclinical state, or how far tumor cells have developed with respect to the total sojourn time. Simulations using MLE and MCMC are used to estimate the sojourn time and age at onset of the preclinical state for male and female heavy smokers in the low dose CT group of the National Lung Screening Trial. This will provide critical information regarding when to start CT screening for heavy smokers.
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