The effect of radiographic emphysema in assessing lung cancer risk

Thorax ◽  
2019 ◽  
Vol 74 (9) ◽  
pp. 858-864 ◽  
Author(s):  
Patrick C Yong ◽  
Keith Sigel ◽  
Juan Pablo de-Torres ◽  
Grace Mhango ◽  
Minal Kale ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Risk ◽  
Cancer Diagnosis ◽  
Lung Cancer Risk ◽  
Risk Scores ◽  
Risk Models ◽  
Lung Cancer Diagnosis ◽  
National Lung Screening Trial ◽  
Lung Screening

PurposeLung cancer risk models optimise screening by identifying subjects at highest risk, but none of them consider emphysema, a risk factor identifiable on baseline screen. Subjects with a negative baseline low-dose CT (LDCT) screen are at lower risk for subsequent diagnosis and may benefit from risk stratification prior to additional screening, thus we investigated the role of radiographic emphysema as an additional predictor of lung cancer diagnosis in participants with negative baseline LDCT screens of the National Lung Screening Trial.MethodsOur cohorts consist of participants with a negative baseline (T0) LDCT screen (n=16 624) and participants who subsequently had a negative 1-year follow-up (T1) screen (n=14 530). Lung cancer risk scores were calculated using the Bach, PLCOm2012 and Liverpool Lung Project models. Risk of incident lung cancer diagnosis at the end of the study and number screened per incident lung cancer were compared between participants with and without radiographic emphysema.ResultsRadiographic emphysema was independently associated with nearly double the hazard of lung cancer diagnosis at both the second (T1) and third (T2) annual LDCT in all three risk models (HR range 1.9–2.0, p<0.001 for all comparisons). The number screened per incident lung cancer was considerably lower in participants with radiographic emphysema (62 vs 28 at T1 and 91 vs 40 at T2).ConclusionRadiographic emphysema is an independent predictor of lung cancer diagnosis and may help guide decisions surrounding further screening for eligible patients.

Biased Lung Cancer Risk Perceptions: Smokers are Misinformed

2018 ◽  
Vol 238 (5) ◽  
pp. 395-421 ◽  
Author(s):  
Nicolas R. Ziebarth
Keyword(s):  
Lung Cancer ◽  
Cancer Risk ◽  
Cancer Diagnosis ◽  
Mortality Risk ◽  
Risk Perceptions ◽  
Lung Cancer Risk ◽  
Lifetime Risk ◽  
Lung Cancer Diagnosis ◽  
Cancer Risk Perceptions ◽  
Overall Mortality

Abstract This paper empirically investigates biased beliefs about the risks of smoking. First, it confirms the established tendency of people to overestimate the lifetime risk of a smoker to contract lung cancer. In this paper’s survey, almost half of all respondents overestimate this risk. However, 80% underestimate lung cancer deadliness. In reality, less than one in five patients survive five years after a lung cancer diagnosis. Due to the broad underestimation of the lung cancer deadliness, the lifetime risk of a smoker to die of lung cancer is underestimated by almost half of all respondents. Smokers who do not plan to quit are significantly more likely to underestimate this overall mortality risk.

Abstract 5298: Lung cancer risk and scarring on imaging and histology in the National Lung Screening Trial

2017 ◽  
Author(s):  
Alison L. Van Dyke ◽  
Christine D. Berg ◽  
Neil E. Caporaso ◽  
Hormuzd A. Katki ◽  
Anil K. Chaturvedi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Risk ◽  
Lung Cancer Risk ◽  
National Lung Screening Trial ◽  
Lung Screening ◽  
Screening Trial

False-positive screens and lung cancer risk in the National Lung Screening Trial: Implications for shared decision-making

2017 ◽  
Vol 25 (2) ◽  
pp. 110-112 ◽  
Author(s):  
Paul F Pinsky ◽  
Christina R Bellinger ◽  
David P Miller
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Risk ◽  
False Positive ◽  
Low Dose ◽  
Lung Cancer Risk ◽  
National Lung Screening Trial ◽  
Low Dose Computed Tomography ◽  
Lung Screening ◽  
Screening Trial

Objectives Low-dose computed tomography lung cancer screening has been shown to reduce lung cancer mortality but has a high false-positive rate. The precision medicine approach to low-dose computed tomography screening assesses subjects’ benefits versus harms based on their personal lung cancer risk, where harms include false-positive screens and resultant invasive procedures. We assess the relationship between lung cancer risk and the rate of false-positive LDCT screens. Methods The National Lung Screening Trial randomized high-risk subjects to three annual screens with low-dose computed tomography or chest radiographs. Following the completion of National Lung Screening Trial, the Lung CT Screening Reporting and Data System (Lung-RADS) classification system was developed and retrospectively applied to National Lung Screening Trial low-dose computed tomography findings. The rate of false-positive screens (by Lung-RADS) and the resultant invasive procedures were examined as a function of lung cancer risk estimated by a model. Results Of 26,722 subjects randomized to the low-dose computed tomography arm, 26,309 received a baseline screen and were included in the analysis. The proportion with any false positive over three screening rounds increased from 12.9% to 25.9% from lowest to highest risk decile, and the proportion with an invasive procedure following a false positive also significantly increased from 0.7% to 2.0% from lowest to highest risk decile. Conclusion These findings indicate a need for personalized low-dose computed tomography lung cancer screening decision aids to accurately convey the benefits to harm trade-off.

Association between previous lung diseases and lung cancer risk: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Lina Ang ◽  
Pratyusha Ghosh ◽  
Wei Jie Seow
Keyword(s):  
Lung Cancer ◽  
Relative Risk ◽  
Cancer Risk ◽  
Cancer Diagnosis ◽  
Fixed Effects ◽  
Lung Diseases ◽  
Lung Cancer Risk ◽  
Chronic Obstructive ◽  
Lung Cancer Diagnosis ◽  
History Of

Abstract Previous lung diseases (PLD) are known risk factors for lung cancer. However, it remains unclear how the association varies by lung cancer subtype and socio-demographic characteristics. We conducted a systematic literature search in three electronic databases from the inception of each database up until 13 January 2021. A total of 73 studies (18 cohort and 55 case–control studies) consisting of 97 322 cases and 7 761 702 controls were included. Heterogeneity was assessed using the I2 statistic. Based on the heterogeneity, either the fixed-effects or random-effects model was used to estimate the pooled summary estimate (PSE) and 95% confidence interval (CI) for the association between PLD and lung cancer risk. A history of asthma, chronic bronchitis, emphysema, pneumonia, tuberculosis, and chronic obstructive pulmonary disease (COPD) was associated with higher lung cancer risk, with a history of COPD and emphysema having at least twofold relative risk. A history of hay fever was associated with lower lung cancer risk (PSE= 0.66, 95% CI= 0.54–0.81), particularly among ever-smokers (PSE= 0.55, 95% CI= 0.41–0.73). Individuals with a diagnosis of asthma, emphysema, or pneumonia within 1–10 years prior to lung cancer diagnosis were observed to have a higher lung cancer risk as compared to those who were diagnosed more than 10 years prior to lung cancer diagnosis. Ever-smokers with a history of COPD or emphysema were observed to have at least twofold relative risk of lung cancer compared to those without this history. Due to the observed association between PLD with higher risk of lung cancer, it is advisable that individuals with PLD should be closely monitored and prioritised for lung cancer screening.

Lung Cancer Risk Associated With New Solid Nodules in the National Lung Screening Trial

2017 ◽  
Vol 209 (5) ◽  
pp. 1009-1014 ◽  
Author(s):  
Paul F. Pinsky ◽  
David S. Gierada ◽  
P. Hrudaya Nath ◽  
Reginald Munden
Keyword(s):  
Lung Cancer ◽  
Cancer Risk ◽  
Lung Cancer Risk ◽  
National Lung Screening Trial ◽  
Lung Screening ◽  
Screening Trial
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