Six-year performance of risk-based selection for lung cancer screening in the Manchester Lung Health Check cohort

Risk-based eligibility using PLCO_m2012 successfully classified most eventual lung cancer cases in the high-risk, screened group. Prediction models generally underestimated risk in this socioeconomically deprived cohort, irrespective of screening status. The effect of screening on increasing the probability of lung cancer diagnosis should be considered when interpreting measures of prediction model performance.