Lung cancer screening recommendations have been developed, but none has focused on veterans. We report the results of the lung cancer screening program at our Veterans Affairs Medical Center and compare them to historic results.
All veterans between 55 and 74 years who were current smokers or quit within the past 15 years and had at least a 30 pack year smoking history were invited to receive an annual low-dose chest computerized tomography (CT) scan beginning in December 2013. Demographics, CT results, and pathologic data of screened patients were recorded retrospectively. Overall results during the screening period were compared to results in veterans diagnosed from January 2011 to December 2013 (pre-screening period).
From December 2013 through December 2014 (screening period) 1,832 patients obtained a screening CT scan. Mean age was 65. A lung nodule was present in 24% (439/1832) of patients. Lung cancer was diagnosed in 3.0% (55/1832) of screened patients. During the pre-screening period, 37% (30/82) of every lung cancer detected at our center was Stage I or Stage II. After implementation of the screening program that percentage rose to 60% (52/87, p <0.01). During the screening period 63% (55/87) of all diagnosed lung cancers were detected through the screening program. The number of lung cancers detected per month rose from 2.4 to 6.7 after implementation of the screening program (p <0.01).
Implementation of lung cancer screening in the veteran population leads to detection of increased number and proportion of early stage lung cancers. Lung cancer screening in veterans may also increase the rate of lung cancer diagnoses in the immediate post-implementation period.