Simulation Study for the Sensitivity and Mean Sojourn Time Spec ificLead Time in Cancer Screening When Human Lifetime is a Competin gRisk

Purpose: The purpose of this paper is to examine the sensitivity and mean sojourn time specific lead time distribution in cancer screening trials when lifetime is a random variable in order to explore possible optimal initial age at screening and screening frequency. Methods: Summarized methods from Wu et al. (2012). Simulation was used in order to estimate the distribution of the lead time for a hypothetical individual with a future screening schedule. The lifetime distribution used comes from the Social Security Administration’s actuarial life tables. The lead time distribution was then calculated based on a loglogistic sojourn time distribution with two mean sojourn times (2, and 10 years), using three different initial screening ages, t0=40, 50, 60, different screening sensitivities (0.3 and 0.5 for men; 0.8 and 0.9 for women), and two different screening frequencies, one and two years for both men and women. Results: Smaller time intervals between screenings yield a smaller probability of no early detection and a greater expected lead time.

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