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• 11358

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  MO11 - Screening and Epidemiology (ID 131)

  • Event: WCLC 2013
  • Type: Mini Oral Abstract Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:P. Zimmerman, J. Bowden
  • Coordinates: 10/28/2013, 16:15 - 17:45, Bayside 201 - 203, Level 2

  • 11361

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    MO11.03 - The natural history and screen-detectability of lung cancer: estimates from NLST and the PLCO (ID 2383)

    16:25 - 16:30  |  Author(s): K. Ten Haaf
    • Abstract
    • Presentation
    • Slides

    Background
    Implementing effective lung cancer screening programs requires extensive knowledge on the natural history of lung cancer and the sensitivity of the proposed screening modality. Data from the National Lung Cancer Screening Trial (NLST), the Prostate, Lung, Colon and Ovarian Cancer Study (PLCO) and Surveillance Epidemiology and End Result (SEER) data from 2004-2008 are used to investigate the screening sensitivity (by stage and histological type) of Computed Tomography (CT) and chest radiography (CXR) and the mean preclinical sojourn time (MPST) of lung cancer (by gender, stage and histological type).

    Methods
    The MISCAN-Lung model was used to reproduce the lung cancer incidence by method of detection (clinical or screen-detected), gender, histology and stage in both trials, by calibrating screening sensitivity and natural history parameters.

    Results
    Major differences in sensitivity between CT and CXR are estimated for the less advanced stages, for example the sensitivity for stage IA adenocarcinoma is estimated to be 56.63% for CT compared to 16.91% for CXR. The model suggests that the MPST varies by histological type and gender. The largest difference between genders was estimated for adenocarcinoma for which the MPST in pre-clinical stages IA to IV was estimated to be 4.48 years for men compared to 6.01 years for women.

    Conclusion
    This study provides detailed insights in the natural history of lung cancer and the differences in the effectiveness of screening between the NLST and PLCO trials. This knowledge may help to determine effective lung cancer screening programs.

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