SESSION TITLE: Lung Cancer Screening & Diagnosis Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: This study sought to determine the percentage of patients undergoing coronary CT (CCT) who also met criteria for lung cancer screening with low dose chest CT (LDCT), and whether any clinical variables might identify candidates to have both studies simultaneously.
METHODS: A retrospective review was conducted of consecutive patients aged 18 to 89 years old who underwent a CCT at San Antonio Military Medical Center between January 2008 and August 2014. We reviewed CCT, all other thoracic imaging, and outpatient records for medical history and tobacco use. Data was analyzed to determine the percentage of patients meeting criteria for lung cancer screening with LDCT (adults aged 55 to 79 years old who are current smokers or former smokers who quit within the last 15 years with a 30+ pack year smoking history) and the frequency of pulmonary nodules.
RESULTS: 1500 patient records were identified of which 586 had complete results for analysis. 10% of patients undergoing CCT were also found to have one or more pulmonary nodules. Overall, 5% of patients who underwent CCT for clinical indications to evaluate heart disease also met age and tobacco history criteria for lung cancer screening. Larger percentages of patients who had CCT partially met criteria for lung cancer screening. 41% of our population satisfied age criteria alone (55-79 years), and 17% of patients met age criteria and additionally had a tobacco use history without documented pack years or timing of cessation. New pulmonary nodules were found on CCT more frequently in smokers compared to non-smokers (16% v 14%)in the overall group, and particularly in smokers aged 55-79 years (21% v 12%).
CONCLUSIONS: A percentage of patients undergoing CCT who met standard criteria for lung cancer screening were incidentally found to have pulmonary nodules, prompting further evaluation with standard chest CT imaging. There is inadequate documentation of smoking history and clinical history at the time of CCT to determine if additional lung imaging is required.
CLINICAL IMPLICATIONS: Determination for lung cancer screening based on documentation of smoking and other pulmonary disease should be assessed prior to performing CCT in all patients meeting age criteria.
DISCLOSURE: The following authors have nothing to disclose: Michelle Alders, Nathan Boyer, Michael Morris, David Bell
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