This study identifies participants ineligible for lung cancer screening with the greatest likelihood of future eligibility. Lung cancer risk in participants enrolled in longitudinal lung screening was assessed using the Prostate, Lung, Colorectal and Ovarian lung cancer risk calculator (PLCO_m2012) at two timepoints: baseline (T₁) and follow-up (T₂). Separate analyses were performed on four PLCO_m2012 eligibility thresholds (3.25%, 2.00%, 1.50%, and 1.00%); only participants with a T₁ risk less than the threshold were included in that analysis. Cox-models identified T₁ risk factors associated with screen-eligibility at T₂. Three models, applying differing assumptions of participant behavior, predicted future eligibility and were benchmarked against the observed cohort. Nine hundred and fifty-six participants had a T₁ risk <3.25%; at 2.00% n= 755; at 1.50% n= 652; at 1.00% n= 484. Lung cancer risk increased over time in most screen-ineligible participants. However, risk increased much faster in participants who became screen-eligible at T₂ compared to those who remained screen-ineligible (median per-year increase of 0.35% versus 0.02%, when using a 3.25% threshold). Participants smoking for >30 years, current smokers, less educated participants, and those with chronic obstructive pulmonary disease (COPD) at T₁ were significantly more likely to become screen-eligible. New diagnoses of COPD and/or non-lung cancers between T₁ and T₂ precipitated eligibility in a subset of participants. The prediction model that assumed health behaviors observed at T₁ continued to T₂ reasonably predicted changes in lung cancer risk. This prediction model and the identified baseline risk factors can identify screen-ineligible participants who should be closely followed for future eligibility.

这项研究确定了不符合肺癌筛查条件的参与者，未来符合条件的可能性最大。_{使用前列腺癌、肺癌、结直肠癌和卵巢癌风险计算器 (PLCO m2012} ) 在两个时间点评估参加纵向肺筛查的参与者的肺癌风险：基线 (T ₁ ) 和随访 (T ₂ )。_{对四个 PLCO m2012}资格阈值（3.25%、2.00%、1.50% 和 1.00%）进行了单独分析；_{该分析仅包括 T 1}风险低于阈值的参与者。Cox 模型确定了与 T 2 筛选资格相关的 T _1风险因素. 三个模型，应用不同的参与者行为假设，预测未来的资格，并以观察到的队列为基准。956 名参与者的 T ₁风险<3.25%；2.00% n = 755；1.50% n = 652；在 1.00% n = 484。在大多数不符合筛查条件的参与者中，肺癌风险随着时间的推移而增加。_{然而，与那些在 T 2 时符合筛查条件的参与者相比，在 T 2}时符合筛查条件的参与者的风险增加得更快（使用 3.25% 的阈值时，平均每年增加 0.35%和0.02%）。_{吸烟超过 30 年的参与者、当前吸烟者、受教育程度较低的参与者以及 T 1}时患有慢性阻塞性肺病 (COPD) 的参与者更有可能成为筛选条件。_{T 1}和 T ₂之间的 COPD 和/或非肺癌的新诊断促成了一部分参与者的资格。假设在 T ₁观察到的健康行为持续到 T ₂的预测模型合理地预测了肺癌风险的变化。该预测模型和已识别的基线风险因素可以识别不符合筛选条件的参与者，这些参与者应被密切关注以获得未​​来的资格。