Abdominal Noncontrast Computed Tomography Scanning to Screen for Kidney Cancer and Other Abdominal Pathology Within Community-based Computed Tomography Screening for Lung Cancer: Results of the Yorkshire Kidney Screening Trial.

Kidney cancer Renal cell carcinoma Screening Smoking

Journal

European urology
ISSN: 1873-7560
Titre abrégé: Eur Urol
Pays: Switzerland
ID NLM: 7512719

Informations de publication

Date de publication:
12 Sep 2024
Historique:
received: 17 04 2024
revised: 08 08 2024
accepted: 20 08 2024
medline: 14 9 2024
pubmed: 14 9 2024
entrez: 13 9 2024
Statut: aheadofprint

Résumé

The Yorkshire Kidney Screening Trial (YKST) assessed the feasibility of adding abdominal noncontrast computed tomography (NCCT) to lung cancer screening to screen for kidney cancer and other abdominal pathology. A prospective diagnostic study offered abdominal NCCT to 55-80-yr-old ever-smokers attending a UK randomised lung cancer screening trial (May 2021 to October 2022). The exclusion criteria were dementia, frailty, previous kidney/lung cancer, and computed tomography (CT) of the abdomen and thorax within previous 6 and 12 mo, respectively. Six-month follow-up was undertaken. A total of 4438 people attended lung screening, of whom 4309 (97%) were eligible for and 4019 (93%) accepted abdominal NCCT. Only 3.9% respondents regretted participating. The additional time to conduct the YKST processes was 13.3 min. Of the participants, 2586 (64%) had a normal abdominal NCCT, whilst 787 (20%) required an abdominal NCCT imaging review but no further action and 611 (15%) required further evaluation (investigations and/or clinic). Of the participants, 211 (5.3%) had a new serious finding, including 25 (0.62%) with a renal mass/complex cyst, of whom ten (0.25%) had histologically proven kidney cancer; ten (0.25%) with other cancers; and 60 (1.5%) with abdominal aortic aneurysms (AAAs). Twenty-five (0.62%) participants had treatment with curative intent. Of the participants, 1017 (25%) had nonserious findings, most commonly benign renal cysts (727 [18%]), whereas only 259 (6.4%) had nonserious findings requiring further tests. The number needed to screen to detect one serious abdominal finding was 18; it was 93 to detect one suspicious renal lesion and 402 to detect one histologically confirmed renal cancer. Limitations of the cohort were fixed age range and being prior lung cancer screening attendees. In this first prospective risk-stratified screening study of abdominal NCCT offered alongside CT thorax, uptake and participant satisfaction were high. The prevalence of serious findings, cancers, and AAAs, is in the range of established screening programmes such as bowel cancer. Longer-term outcomes and cost effectiveness should now be evaluated.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
The Yorkshire Kidney Screening Trial (YKST) assessed the feasibility of adding abdominal noncontrast computed tomography (NCCT) to lung cancer screening to screen for kidney cancer and other abdominal pathology.
METHODS METHODS
A prospective diagnostic study offered abdominal NCCT to 55-80-yr-old ever-smokers attending a UK randomised lung cancer screening trial (May 2021 to October 2022). The exclusion criteria were dementia, frailty, previous kidney/lung cancer, and computed tomography (CT) of the abdomen and thorax within previous 6 and 12 mo, respectively. Six-month follow-up was undertaken.
KEY FINDINGS AND LIMITATIONS UNASSIGNED
A total of 4438 people attended lung screening, of whom 4309 (97%) were eligible for and 4019 (93%) accepted abdominal NCCT. Only 3.9% respondents regretted participating. The additional time to conduct the YKST processes was 13.3 min. Of the participants, 2586 (64%) had a normal abdominal NCCT, whilst 787 (20%) required an abdominal NCCT imaging review but no further action and 611 (15%) required further evaluation (investigations and/or clinic). Of the participants, 211 (5.3%) had a new serious finding, including 25 (0.62%) with a renal mass/complex cyst, of whom ten (0.25%) had histologically proven kidney cancer; ten (0.25%) with other cancers; and 60 (1.5%) with abdominal aortic aneurysms (AAAs). Twenty-five (0.62%) participants had treatment with curative intent. Of the participants, 1017 (25%) had nonserious findings, most commonly benign renal cysts (727 [18%]), whereas only 259 (6.4%) had nonserious findings requiring further tests. The number needed to screen to detect one serious abdominal finding was 18; it was 93 to detect one suspicious renal lesion and 402 to detect one histologically confirmed renal cancer. Limitations of the cohort were fixed age range and being prior lung cancer screening attendees.
CONCLUSIONS AND CLINICAL IMPLICATIONS CONCLUSIONS
In this first prospective risk-stratified screening study of abdominal NCCT offered alongside CT thorax, uptake and participant satisfaction were high. The prevalence of serious findings, cancers, and AAAs, is in the range of established screening programmes such as bowel cancer. Longer-term outcomes and cost effectiveness should now be evaluated.

Identifiants

DOI: 10.1016/j.eururo.2024.08.029 PMID: 39271419
pubmed: 39271419
pii: S0302-2838(24)02567-3
doi: 10.1016/j.eururo.2024.08.029
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

Auteurs

Grant D Stewart (GD)

Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; CRUK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK. Electronic address: gds35@cam.ac.uk.

Angela Godoy (A)

CRUK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Oncology, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.

Fiona Farquhar (F)

Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Jessica Kitt (J)

Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; CRUK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK.

Jon Cartledge (J)

Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Michael Kimuli (M)

Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Sabrina H Rossi (SH)

Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; CRUK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK.

Bethany Shinkins (B)

Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Simon Burbidge (S)

Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Sarah W Burge (SW)

CRUK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Oncology, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.

Iztok Caglic (I)

Department of Radiology, University of Cambridge, Cambridge, UK.

Emma Collins (E)

Department of Endocrine Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Philip A J Crosbie (PAJ)

Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.

Claire Eckert (C)

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Sheila Fraser (S)

Department of Endocrine Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Neil Hancock (N)

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Gareth R Iball (GR)

School of AHP & Midwifery, Faculty of Health Studies, University of Bradford, Bradford, UK.

Catriona Marshall (C)

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Golnessa Masson (G)

Pitcairn Practice, Balmullo Surgery, Fife, UK.

Richard D Neal (RD)

Exeter Collaboration for Academic Primary Care (APEx), University of Exeter, Exeter, UK.

Suzanne Rogerson (S)

Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Andrew Smith (A)

The Pancreas Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Stephen J Sharp (SJ)

MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.

Irene Simmonds (I)

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Tom Wallace (T)

Leeds Vascular Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Matthew Ward (M)

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Matthew E J Callister (MEJ)

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Juliet A Usher-Smith (JA)

CRUK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.

Classifications MeSH