Imaging |

Radiographic Findings and Lifestyle Modification Findings From a Two-and-a-Half Year Lung Cancer Screening Program in an Area Endemic for Valley Fever FREE TO VIEW

Nicholas Matthees; Hasnain Hasham; Craig Johnson; Taylor Ipsen; Kristina Chapple; Amy Christenson; Veta Markland-Gentles; Enise Yoo-Liu; Ralph Drosten; Stanton Nielsen; Amy Trahan; Mirella Mircescu; Priyumvada Naik; Elbert Kuo, MPH
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St. Joseph's Hospital, Phoenix, AZ

Chest. 2014;146(4_MeetingAbstracts):577A. doi:10.1378/chest.1994052
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SESSION TITLE: Ultrasound and Other Imaging Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The purpose of this study is to examine the efficacy of a lung cancer screening program in a coccidioidomycosis endemic area. In addition, we analyzed patient lifestyle modifications including smoking cessation, diet, and exercise as a part of the program.

METHODS: Patients were referred by physicians or were self-referred beginning in September 2011. A team of pulmonologists, thoracic radiologists, oncologists, thoracic surgeons, infectious disease specialists, cardiologists and primary care doctors developed a scoring system that took into account a patient’s age, smoking history, and family history of lung cancer. Patients meeting pre-determined criteria were screened with a low dose CT scan and imaging findings were reviewed in a multi-disciplinary committee. Patients were given a free physician consultation to discuss results as well as counseling on smoking cessation. A follow-up telephone questionnaire was conducted of the first 100 patients to evaluate participants for changes in their smoking habits, exercise, and dietary changes since the screening.

RESULTS: Radiological findings are based on 329 patients screened between September 2011 and December 2013. 86% of participants were diagnosed with pulmonary findings and 85% with non-pulmonary findings. 58% of patients had non-calcified pulmonary nodules and 27% had calcified granulomas. Despite the high number of nodules found, only 2% underwent PET scanning and 2% had a CT guided biopsy. Lung cancer was found in 3 patients. One patient was diagnosed with breast cancer and one patient with lymphoma. 34% of patients had calcified coronary artery disease. 33% of patients quit smoking; 46% decreased smoking. 36% reported improvements in diet and 34% increased exercise time per week at 6 month followup after counseling.

CONCLUSIONS: Lung cancer screening programs can be successfully implemented in areas with high pulmonary nodule rates in a responsible manner minimizing risk, unnecessary testing, and patient harm while saving lives and resulting in important lifestyle changes in a high risk population.

CLINICAL IMPLICATIONS: Lung cancer screening is a teachable moment where physicians can discuss smoking cessation and other healthy lifestyle changes with their patients. Screening in a coccidioidomycosis endemic area results in more false positives, but can be successfully implemented to avoid unneccesary testing with a multidisciplinary approach.

DISCLOSURE: The following authors have nothing to disclose: Nicholas Matthees, Hasnain Hasham, Craig Johnson, Taylor Ipsen, Kristina Chapple, Amy Christenson, Veta Markland-Gentles, Enise Yoo-Liu, Ralph Drosten, Stanton Nielsen, Amy Trahan, Mirella Mircescu, Priyumvada Naik, Elbert Kuo

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