SESSION TYPE: Lung Cancer Posters I
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: The optimal population for lung cancer screening with low dose chest computed tomography (CT) remains to be determined. Recommended clinical follow-up was compared between groups of subjects with and without airflow obstruction and radiographic emphysema.
METHODS: A retrospective review of 100 subjects enrolled in a lung cancer screening study was performed. Recommended clinical follow-up was compared between subjects with and without airflow obstruction (defined as FEV1/VC <70%) and between subjects with and without radiographic emphysema (qualitative assessment by study radiologist).
RESULTS: At least one non-calcified nodule (NCN) was detected among 18 of the 33 subjects with airflow obstruction, compared to 17 of the 30 subjects without obstruction (54.5% vs. 56.7%). Follow-up prior to 12 months was recommended for 7 subjects with obstruction, compared to 4 subjects without obstruction (21.2% vs. 13.3%, p=0.41). Among the 9 subjects with at least moderate airflow obstruction (FEV1 <70% predicted), 6 had at least one NCN, and follow-up prior to 12 months was recommended in 4 (44.4%, p=0.04 compared to no obstruction group). At least one NCN was detected among 15 of the 32 subjects with radiographic emphysema, compared to 39 of the 68 subjects without emphysema (46.9% vs. 57.4%). Follow-up prior to 12 months was recommended for 7 subjects with emphysema, compared to 8 subjects without emphysema (21.9% vs. 11.8%, p=0.19). Among the 9 subjects with at least moderate radiographic emphysema, 6 had at least one NCN, and follow-up prior to 12 months was recommended in 4 (44.4%, p=0.01 compared to no emphysema group). None of the nodules that prompted early follow-up demonstrated growth suggestive of malignancy on repeat CT scan.
CONCLUSIONS: Early clinical follow-up was recommended more often for subjects with at least moderate airflow limitation or radiographic emphysema.
CLINICAL IMPLICATIONS: Subjects with obstructive lung disease are likely to require earlier follow-up than those without lung disease but do not appear to be at significant risk for newly-diagnosed lung cancer within the first year of screening.
DISCLOSURE: The following authors have nothing to disclose: Mark Yoder, Palmi Shah, Edward Hong, Michael Liptay, James Mulshine
lung cancer screening is considered research by many professional organizations at this point in timeRush University Medical Center, Chicago, IL