Lung Cancer Screening With Low Dose Computed Tomography in Patients With and Without Prior History of Cancer in the National Lung Screening Trial.
Low dose computed tomography
Lung cancer
Prior history of cancer
Screening
Journal
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
ISSN: 1556-1380
Titre abrégé: J Thorac Oncol
Pays: United States
ID NLM: 101274235
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
08
11
2020
revised:
06
01
2021
accepted:
02
02
2021
pubmed:
14
2
2021
medline:
8
7
2021
entrez:
13
2
2021
Statut:
ppublish
Résumé
Patients with a prior history of cancer (PHC) are at increased risk of second primary malignancy, of which lung cancer is the most common. We compared the performance metrics of positive screening rates and cancer detection rates (CDRs) among those with versus without PHC. We conducted a secondary analysis of 26,366 National Lung Screening Trial participants screened with low dose computed tomography between August 2002 and September 2007. We evaluated absolute rates and age-adjusted relative risks (RRs) of positive screening rates on the basis of retrospective Lung CT Screening Reporting & Data System (Lung-RADS) application, invasive diagnostic procedure rate, complication rate, and CDR in those with versus without PHC using a binary logistic regression model using Firth's penalized likelihood. We also compared cancer type, stage, and treatment in those with versus without PHC. A total of 4.1% (n = 1071) of patients had PHC. Age-adjusted rates of positive findings were similar in those with versus without PHC (Baseline: PHC = 13.7% versus no PHC = 13.3%, RR [95% confidence interval (CI)]: 1.04 [0.88-1.24]; Subsequent: PHC = 5.6% versus no PHC = 5.5%, RR [95% CI]: 1.02 [0.84-1.23]). Age-adjusted CDRs were higher in those with versus without PHC on baseline (PHC=1.9% versus no PHC = 0.8%, RR [95% CI]: 2.51 [1.67-3.81]) but not on subsequent screenings (PHC = 0.6% versus no PHC = 0.4%, RR [95% CI]: 1.37 [0.99-1.93]). There were no differences in cancer stage, type, or treatment by PHC status. Patients with PHC may benefit from lung cancer screening, and with their providers, should be made aware of the possibility of higher cancer detection, invasive procedures, and complication rates on baseline lung cancer screening, but not on subsequent low dose computed tomography screening examinations.
Identifiants
pubmed: 33581343
pii: S1556-0864(21)01703-2
doi: 10.1016/j.jtho.2021.02.003
pmc: PMC8159850
mid: NIHMS1679650
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
980-989Subventions
Organisme : NCI NIH HHS
ID : R01 CA212014
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA251686
Pays : United States
Informations de copyright
Copyright © 2021 International Association for the Study of Lung Cancer. All rights reserved.
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