Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
Copyright 2016, American College of Chest Physicians. All Rights Reserved.
SESSION TITLE: Lung Cancer: Imaging
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM
PURPOSE: The overall 5 years survival for lung cancer patients is approximately 16%, a survival advantage is noted for early stage lung cancer, with 5-year survivals up to 65%. However, only 10% patients are diagnosed when the primary tumor is resectable. Our trial was aimed to improve the early stage lung cancer detection rate using low-dose CT (LDCT).
METHODS: Eligible participants enrolled in our trial were local residents in 6 communities located in Xuhui District, Shanghai, China, aged from 45 to 70 years and with either of the following risk factors: 1) history of cigarette smoking ≥20 pack-years, and, if former smokers, had quit within the previous 15 years; 2) malignant tumors history in immediate family members; 3) personal cancer history; 4) professional exposure to carcinogens; 5) long term exposure to second-hand smoke; 6) long term exposure to cooking oil fumes. From November 2013 to November 2014, the high risk residents received free chest LDCT scans at Shanghai Jiaotong University Affiliated Shanghai Chest Hospital. The findings of CT scan were identified by three experts. The shadows on the lungs were grouped accordingly. If imaging was highly suggestive of malignancy, the expert group would have further discussion. The residents would be assigned to undergo biopsy or surgical resection directly.
RESULTS: Up to January 2015, 2933 participants were received LDCT screening. According to the inclusion criteria, 2892 persons at high risk for lung cancer were included in our trail, and 41 cases were finally excluded. Of the 2892 aged 45-70 years old cases, the median age was 61 years old. Of the included participants, 1151 cases were male, and 1741 cases were female. Pulmonary small nodules were found in 742 cases; small nodules detection rate was 25.66% (742/2892). 69 cases were suspected of lung cancer. Accounting for pulmonary small nodules was 9.30% (69/742), and was 2.39% (69/2892) of the total number of screening high risk population. 23 cases underwent surgery, with 22 lung cancer (10 males and 12 females) and 1 hamartoma, representing a positive lung cancer detection rate with LDCT screening of 0.76% (22/2892). 21 of the 22 cases resected lung cancers were stage I (95.45%) and 1 was stage II (4.55%), with 21 adenocarcinomas (95.45%) and 1 squamous lung cancer (4.55%).
CONCLUSIONS: The application of LDCT screening prompted an increase detection rate of early stage lung cancers (stage I and II) in the high risk population.
CLINICAL IMPLICATIONS: LDCT screening could increase detection rate of early stage lung cancer.
DISCLOSURE: The following authors have nothing to disclose: Huiming Wang, Jiajun Teng, Yanwei Zhang, Qunhui Chen, Jianding Ye, Jiatao Lou, Rong Shi, Bo Jin, Xueyan Zhang, Jianlin Xu, Xue Dong, Yuqing Lou, Baohui Han
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