“Early impact” of the lung cancer screening in United States population in the SEER Registries.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1569-1569
Author(s):  
Isabel M Emmerick ◽  
John M. Varlotto ◽  
Maggie M Powers ◽  
Feiran Lou ◽  
Poliana Lin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Late Stage ◽  
Early Stage ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Median Income ◽  
Early Late ◽  
Patient Subgroups

1569 Background: The Lung Cancer Screening Trial (NLST) demonstrated improved overall survival (OS) and lung cancer specific survival (LCSS), likely due to finding early-stage NSCLC. Our study investigates the impact of the NLST publication in 2011 on the lung cancer outcomes in the general US Population by assessing the incidence rates, ratio of early/late stage, and lung cancer mortality in the years immediately prior to and following this publication. Methods: Rate sessions from the SEER18 database were accessed during the years 2008-2015. We analyzed overall lung cancer incidence and mortality rates. The ratio of early/late stage was obtained by dividing the number of stage I and II cases by the number of stage III and IV diagnosed by year. We investigate changes in level and trend using interrupted time series in STATA12, considering 2011 as the intervention. In addition, we performed a T-test for averages ratios comparing the years 2007-2010 to the years 2012-2015 for the entire lung cancer population and for subgroups by median family, ethnicity, Sex, Age and SEER Registry. Results: Although the overall lung cancer rates remained stable during the study period, a significant increase in the ratio of early/late stage was observed following the release of NLST for the overall lung cancer population (p=0.006) and for the screening age group (p= 0.014). The effects of ratio of early/late stage as noted in the overall group persisted for all patient subgroups, except for patients associated with a median income <$40,000, for those there were white, and for the following regions Detroit Metro, Iowa, Greater and Rural Georgia and Louisiana where no association was found between the release of the NLST changes in the ratios of early detection even more, in some cases there was a decrease in late stage detection. There was no impact on lung cancer mortality in the general lung cancer population or in any patient subgroups. Conclusions: Since the publication of the NLST in 2011, there has been no impact on lung cancer mortality or incidence of lung cancer in the general US population. However, favorable increase in the proportion of early stage lung cancers, depending upon median family income, race and location. We expected a greater impact of lung cancer screening after 2015 since CT-screening for lung cancer was adopted by CMS and other insurances during that year.

Lung Cancer Screening: Promise and Pitfalls

2012 ◽  
pp. 450-457
Author(s):  
Christine D. Berg ◽  
Denise R. Aberle ◽  
Douglas E. Wood
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Medical Community ◽  
Helical Computed Tomography ◽  
Screening Guidelines ◽  
Screening Programs ◽  
National Lung Screening Trial

OVERVIEW: The results of the National Lung Screening Trial (NLST) have provided the medical community and American public with considerable optimism about the potential to reduce lung cancer mortality with imaging-based screening. Designed as a randomized trial, the NLST has provided the first evidence of screening benefit by showing a 20% reduction in lung cancer mortality and a 6.7% reduction in all-cause mortality with low dose helical computed tomography (LDCT) screening relative to chest X-ray. The major harms of LDCT screening include the potential for radiation-induced carcinogenesis; high false-positivity rates in individuals without lung cancer, and overdiagnosis. Following the results of the NLST, the National Comprehensive Cancer Network (NCCN) published the first of multiple lung cancer screening guidelines under development by major medical organizations. These recommendations amalgamated screening cohorts, practices, interpretations, and diagnostic follow-up based on the NLST and other published studies to provide guidance for the implementation of LDCT screening. There are major areas of opportunity to optimize implementation. These include standardizing practices in the screening setting, optimizing risk profiles for screening and for managing diagnostic evaluation in individuals with indeterminate nodules, developing interdisciplinary screening programs in conjunction with smoking cessation, and approaching all stakeholders systematically to ensure the broadest education and dissemination of screening benefits relative to risks. The incorporation of validated biomarkers of risk and preclinical lung cancer can substantially enhance the effectiveness screening programs.

An Actuarial Approach to Comparing Early Stage and Late Stage Lung Cancer Mortality and Survival

2010 ◽  
Vol 13 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Sara W. Goldberg ◽  
James L. Mulshine ◽  
Dale Hagstrom ◽  
Bruce S. Pyenson
Keyword(s):  
Lung Cancer ◽  
Cancer Mortality ◽  
Late Stage ◽  
Early Stage ◽  
Lung Cancer Mortality ◽  
Actuarial Approach ◽  
Stage Lung Cancer

scholarly journals State Variation in Low-Dose Computed Tomography Scanning for Lung Cancer Screening in the United States

2020 ◽  
Author(s):  
Stacey A Fedewa ◽  
Ella A Kazerooni ◽  
Jamie L Studts ◽  
Robert A Smith ◽  
Priti Bandi ◽  
...  
Keyword(s):  
United States ◽  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Low Dose ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
The United States ◽  
Cancer Burden

Abstract Background Annual lung cancer screening (LCS) with low-dose chest computed tomography in older current and former smokers (ie, eligible adults) has been recommended since 2013. Uptake has been slow and variable across the United States. We estimated the LCS rate and growth at the national and state level between 2016 and 2018. Methods The American College of Radiology’s Lung Cancer Screening Registry was used to capture screening events. Population-based surveys, the US Census, and cancer registry data were used to estimate the number of eligible adults and lung cancer mortality (ie, burden). Lung cancer screening rates (SRs) in eligible adults and screening rate ratios with 95% confidence intervals (CI) were used to measure changes by state and year. Results Nationally, the SR was steady between 2016 (3.3%, 95% CI = 3.3% to 3.7%) and 2017 (3.4%, 95% CI = 3.4% to 3.9%), increasing to 5.0% (95% CI = 5.0% to 5.7%) in 2018 (2018 vs 2016 SR ratio = 1.52, 95% CI = 1.51 to 1.62). In 2018, several southern states with a high lung-cancer burden (eg, Mississippi, West Virginia, and Arkansas) had relatively low SRs (&lt;4%) among eligible adults, whereas several northeastern states with lower lung cancer burden (eg, Massachusetts, Vermont, and New Hampshire) had the highest SRs (12.8%-15.2%). The exception was Kentucky, which had the nation’s highest lung cancer mortality rate and one of the highest SRs (13.7%). Conclusions Fewer than 1 in 20 eligible adults received LCS nationally, and uptake varied widely across states. LCS rates were not aligned with lung cancer burden across states, except for Kentucky, which has supported comprehensive efforts to implement LCS.

scholarly journals Lung Cancer Screening: Evidence, Risks, and Opportunities for Implementation

2021 ◽  
Author(s):  
Giulia Tringali ◽  
Gianluca Milanese ◽  
Roberta Eufrasia Ledda ◽  
Ugo Pastorino ◽  
Nicola Sverzellati ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Implementation Strategies ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Current Evidence ◽  
Screening Practice ◽  
Pubmed Search ◽  
The Uk

Background Lung cancer is the most common cause of cancer death worldwide. Several trials with different screening approaches have recognized the role of lung cancer screening with low-dose CT for reducing lung cancer mortality. The efficacy of lung cancer screening depends on many factors and implementation is still pending in most European countries. Methods This review aims to portray current evidence on lung cancer screening with a focus on the potential for opportunities for implementation strategies. Pillars of lung cancer screening practice will be discussed according to the most updated literature (PubMed search until November 16, 2020). Results and Conclusion The NELSON trial showed reduction of lung cancer mortality, thus confirming previous results of independent European studies, notably by volume of lung nodules. Heterogeneity in patient recruitment could influence screening efficacy, hence the importance of risk models and community-based screening. Recruitment strategies develop and adapt continuously to address the specific needs of the heterogeneous population of potential participants, the most updated evidence comes from the UK. The future of lung cancer screening is a tailored approach with personalized continuous stratification of risk, aimed at reducing costs and risks. Key Points:  Citation Format

scholarly journals Safety and Effectiveness of Lung Cancer Screening Using Low-dose Computed Tomography Scan in High-risk Individuals: A Comprehensive Review

2021 ◽  
Author(s):  
Sara Mohamadi ◽  
Rajabali Daroudi ◽  
Mohamadreza Mobinizadeh
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Cancer Mortality ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Comprehensive Review ◽  
Incidence And Mortality ◽  
Technical Specifications

Context: Lung cancer is the most important cause of cancer mortality. Given the incidence and mortality of this disease, the implementation of preventive interventions is necessary. Objectives: The present study investigated the effectiveness of one of the most important interventions of lung cancer screening with lowdose computed tomography (LDCT) in high-risk individuals. Evidence Acquisition: The present study was an applied study performed as a comprehensive review. For the assessment of safety, studies on the technical specifications of computed tomography scans and issues related to the safety of applying this device were searched using keywords in medical databases. For the evaluation of clinical effectiveness, a comprehensive review of health technology assessment studies, systematic review studies, and screening guidelines was performed. Results: Based on 15 studies extracted for the safety issue, the diagnosis of harmless tumors, false positives cases and Unnecessary invasive complementary interventions, and possible negative effects of radiation exposure are discussable safety issues. Based on the synthesis of 16 studies on effectiveness, lung cancer screening intervention using LDCT was determined to reduce lung cancer mortality by 15 - 20% and mortality from other causes by 0 - 6%. Additionally, the incidence of this disease in its upper stages decreases significantly. Conclusions: Lung cancer screening using LDCT does not threaten the health of individuals seriously and, in comparison to nonintervention is more clinically effective and will lead to a statistically significant reduction in lung cancer mortality and increase in the timely diagnosis of this disease.  

scholarly journals Long-Term Follow Up of an Occupational Cohort in Yunnan, People’s Republic of China: 20-Year Postscreening Follow Up and 8-Year Lung Cancer Screening

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 23-23
Author(s):  
Zheng Su ◽  
Meng-Na Wei ◽  
Ya-Guang Fan ◽  
Zhi-Wei Hu ◽  
Jian-Ning Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Age Groups ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
People's Republic Of China ◽  
Republic Of China

PURPOSE There is no long-term, population-based cohort screening evidence for lung cancer in China. This study aimed to evaluate whether increased screening rounds could reduce mortality as a result of lung cancer. METHODS We conducted a one-armed, prospective lung cancer screening cohort study with chest radiography and sputum cytology in Yunnan, People’s Republic of China, from 1992 to 1999. A total of 9,295 tin miners age 40 years or older were enrolled in this study and follow up ended on December 31, 2018. We stratified patients into 4 subgroups on the basis of screening rounds—1-2, 3-4, 5-6, or 7-8 rounds within 8 years—and selected 1-2 screening rounds within 8 years as the control group. Hazard ratios (HRs) and 95% CIs for the effect of screening rounds on mortality were estimated using Cox proportional hazards regression models. RESULTS Of participants, 831 (8.9%) were lost to follow up, and 4,517 patients died, 1,600 from cancer (1,135 from lung cancer), 1,519 from circulatory system diseases, and 619 from respiratory diseases. Participants who received 7-8 screening rounds within 8 years had reduced lung cancer mortality by 46% (HR, 0.54; 95% CI, 0.46 to 0.63 in all age groups. For those who received 5-6 screening rounds within 8 years, the benefit of reduction was mostly observed in patients older than age 52 years (HR, 0.63; 95% CI, 0.52 to 0.77), and there was no effect among those age 52 years or younger (HR, 0.72; 95% CI, 0.48 to 1.07). In contrast, only for those patients age 52 years or younger did 3-4 screening rounds within 8 years decrease mortality from lung cancer (HR, 0.56; 95% CI, 0.36 to 0.87). CONCLUSION We showed that increased screening rounds could reduce lung cancer mortality in a high-risk population, but the effect is influenced by age group. The optimal screening strategy for different age groups needs additional investigation.

Exploring the Impact of Lung Cancer Screening on Lung Cancer Mortality of Smokers With Obstructive Lung Disease: Analysis of the NLST-ACRIN Cohort

2021 ◽  
Vol 57 (1) ◽  
pp. 36-41
Author(s):  
Juan P. de-Torres ◽  
Juan P. Wisnivesky ◽  
Gorka Bastarrika ◽  
David O. Wilson ◽  
Bartolome R. Celli ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Disease ◽  
Cancer Mortality ◽  
Obstructive Lung Disease ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
The Impact ◽  
Disease Analysis

scholarly journals The Prefectural Participation Rates of Lung Cancer Screening Had a Negative Correlation with the Lung Cancer Mortality Rates

2019 ◽  
Vol 20 (3) ◽  
pp. 855-861 ◽  
Author(s):  
Motoyasu Sagawa ◽  
Ryoko Machii ◽  
Tomio Nakayama ◽  
Takafumi Sugawara ◽  
Naoya Isgibashi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Negative Correlation ◽  
Cancer Mortality ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Mortality Rates ◽  
Participation Rates
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