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S. Gupta



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    MO11 - Screening and Epidemiology (ID 131)

    • Event: WCLC 2013
    • Type: Mini Oral Abstract Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      MO11.13 - Low selenium serum level is a good preselection factor for patients invited for low dose chest CT lung cancer screening (ID 823)

      17:20 - 17:25  |  Author(s): S. Gupta

      • Abstract
      • Presentation
      • Slides

      Background
      Selenium is known as a chemoprotective anti-cancer agent. The impact of low selenium serum level on the frequency of early lung cancer (LC) detection rate in patients participating in a low dose chest CT (LDCT) screening program is assessed.

      Methods
      A program of early LC detection was conducted in a single city of 400000 inhabitants from 2008 till 2011 (Protocol I). Enrollment criteria included both sexes aged 55-65 years with a history of 20 pack-years of tobacco smoking. All detected lesions were followed up in accordance with IELCAP protocols. A new pilot study (Protocol II) launched in 2012 was based on preselection of the participants by measure of their selenium serum level. Only individuals with a low selenium level (< 75 microgramms/ml) were invited for CT scans. Other enrollment criteria were the same as in Protocol I. All cases requiring surgery were referred to a single local thoracic surgery department. The following data were analyzed: number of all detected lesions as well as LC detected in both protocols.

      Results
      Protocol I: 15020 patients were screened by LDCT. 6240 pulmonary lesions were detected with the majority (59%) smaller than 5mm. 182 patients (2.9% of all detected lesions) were referred for thoracic surgery. 119 primary LC were diagnosed and treated. Protocol II: 2440 patients have had selenium serum level measured. 720 of them were screened by LDCT. 210 lesions were detected with 49% smaller than 5mm. 14 patients (6.8%) were referred for thoracic surgery. 9 primary LC were diagnosed and treated surgically. Protocol II was more specific because number of all detected lesions was significantly smaller than in Protocol I (p < 0.0001, OR: 0.55; CI: 0.46 – 0.64) but the LC detection rate in Protocol II was more than twice as high as in Protocol I (p = 0.0226, OR: 2.38; CI: 1.19 – 4.76).

      Conclusion
      The detection rate of LC in the program of early detection based on LDCT is higher if the protocol is supported by preselection of high risk tobacco - smoking patients based on a low level of selenium in serum.

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