Assessing risk-based LDCT screening strategies versus the current USPSTF lung cancer screening recommendations at an institutional setting.

e13572 Background: Lung cancer is the leading cause of cancer related deaths in men and women with 1.76 million deaths worldwide in 2018 [1]. Given its high prevalence and mortality, trials were developed to improve screening strategies. National-Lung-Screening-Trial showed a 20% relative-risk-reduction in mortality in people screened with annual low-dose-CT-scan [2] leading to the implementation of current USPSTF guidelines. We used USPSTF screening criteria to estimate the proportion of non-small cell lung cancer (NSCLC) patients that would have been screening-eligible at our institution.Upon chart review 33% of overall lung cancer patients at our institution did not meet the screening guidelines. We decided to investigate the need to modify the current screening guidelines of our institution based on individual risk assessment. Methods: We conducted a retrospective observational cohort study of the new diagnoses at Louisiana-State-University-Shreveport from 2011-2015. Patients were categorized into high-risk (groups 1 and 2), moderate risk, and low risk according to 2018 NCCN Lung Cancer Screening Guidelines Version 1.2020 [3]. To differentiate between high-risk group 2 and moderate risk, the Tammemagi lung cancer risk calculator was employed, considering 1.3% threshold of lung cancer risk over 6-year time frame [4]. According to NCCN, high-risk group 1 and 2 are eligible for annual low-dose-CT-scan. Results: 33% of overall lung cancer patients at our institution did not meet the screening guidelines criteria, among the 33% ineligible for screening, only 12.5% fell under the high-risk category based on the Tammemagi calculator. Conclusions: Despite using individual risk assessment based on Tammemagi calculator, 87.5% of lung cancer patients ineligible to current USPSTF guidelines are still missing the eligibility for screening at our institution. We believe more efficient risk prediction models have to be developed to improve selection of individuals for lung cancer screening.

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Surgically treated lung cancer patients: do they all smoke and would they all have been detected with lung cancer screening?

ERJ Open Research ◽

10.1183/23120541.00001-2018 ◽

2018 ◽

Vol 4 (3) ◽

pp. 00001-2018 ◽

Cited By ~ 1

Author(s):

Tanel Laisaar ◽

Bruno Sarana ◽

Indrek Benno ◽

Kaja-Triin Laisaar

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Cancer Patients ◽

Lung Cancer Screening ◽

University Hospital ◽

Smoking History ◽

Inclusion Criteria ◽

Lung Cancer Patients ◽

Cancer Screening Trial ◽

Lung Cancer Detection

Since publication of the National Lung Cancer Screening Trial (NLST) results early lung cancer detection has been widely studied, targeting individuals based on smoking history and age. However, over recent decades several changes in lung cancer epidemiology, including risk factors, have taken place. The aim of the current study was to explore smoking prevalence among lung cancer patients who had been treated surgically or undergone a diagnostic operation and whether these patients would have met the NLST inclusion criteria.All patients operated on for lung cancer in a university hospital in Estonia between 2009 and 2015 were included. Data were collected from hospital records.426 patients were operated on for lung cancer, with smoking history properly documented in 327 patients (87 females; median age 67 years). 170 (52%) patients were smokers, 97 (30%) patients were ex-smokers and 60 (18%) patients were nonsmokers. The proportion of females among smokers was 15%, among ex-smokers was 9% and among nonsmokers was 87%. 107 of our patients would not have met the NLST age criteria and 128 of our patients would not have met the NLST smoking criteria. In total, 183 patients (56% (79% of females and 48% of males)) would not have met the NLST inclusion criteria.Only half of surgically treated lung cancer patients were current smokers and more than half did not meet the NLST inclusion criteria.

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9039 Lung cancer screening with low dose spiral CT and autofluorescence bronchoscopy in high risk group

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(09)71752-5 ◽

2009 ◽

Vol 7 (2) ◽

pp. 517

Author(s):

L. Eun Woo ◽

L. Jung Hwan ◽

C. Dong Ryeol ◽

K. Sung Soo ◽

L. Yong Gik

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

High Risk ◽

Low Dose ◽

Risk Group ◽

Lung Cancer Screening ◽

Spiral Ct ◽

High Risk Group ◽

Autofluorescence Bronchoscopy

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Implementing physician education to increase lung cancer screening compliance.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18282 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18282-e18282

Author(s):

Coral Olazagasti ◽

Devi Sampat ◽

Adam Rothman ◽

Nagashree Seetharamu ◽

David Steiger

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

High Risk ◽

Lung Cancer Screening ◽

Physician Education ◽

Smoking History ◽

Post Intervention ◽

Screening Criteria ◽

Screening Guidelines ◽

Internal Medicine Clinic

e18282 Background: Lung cancer is the leading cause of cancer-related deaths worldwide. The USPSTF recommends annual low-dose CT chest (LDCT) for lung cancer screening in adults who meet the appropriate criteria: age 55-80, current smokers or former smokers who quit within 15years, with a 30 pack-year smoking history. Even with these recommendations, screening rates in these patients remain low. We created a study to assess compliance in an outpatient Internal Medicine clinic to assess the barriers for obtaining LDCT. We hypothesized that by providing an educational program, overall compliance would increase. Methods: The study was divided in two arms: a pre-intervention arm and a post-intervention assessment. Initially, 35 physicians completed a questionnaire on their attitudes to LDCT screening and their reasons for not screening high risk patients. We created a lung cancer screening education program, which consisted of lectures provided to physicians. Following the lectures, consecutive patient visits were reviewed to assess compliance with screening. Results: In the first arm, 678 visits were reviewed. 115 patients met USPSTF criteria of whom only 26% underwent screening with LDCT. The most common reasons for not ordering LDCT scans in patients meeting criteria included: poor knowledge of criteria (22%), failure to determine if patients qualified (13%), patient refusal (8%). Following the education, 208 patients out of the 955 visits reviewed met USPSTF criteria, of which 78% underwent LDCT. Our study showed how after education, physicians were ten times more likely to screen patients for lung cancer (Odds ratio 9.98, 95% CI 5.87-16.94, p < 0.0001). Conclusions: We confirmed there was suboptimal adherence to established LDCT lung cancer screening guidelines, mainly due to unfamiliarity with the screening criteria. By providing educational lectures, compliance improved significantly. We concluded that educating physicians about lung cancer screening guidelines increased LDCT screening tenfold, and therefore benefit patients that are at high risk for developing lung cancer.

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