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W. Moore
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P1.06 - Poster Session/ Screening and Early Detection (ID 218)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.06-002 - Lung Cancer Screening Guidelines May Not Capture the Complete Population At-Risk (ID 525)
09:30 - 09:30 | Author(s): W. Moore
- Abstract
Background:
In December 2013, the United States Preventive Services Task Force (USPSTF) provided a level B recommendation for the use of low-dose computed tomography (LDCT) to screen high-risk patients for lung cancer. Most recently, in February 2015, the Centers for Medicare and Medicaid Services (CMS) likewise approved coverage for at-risk patients, defined as those 55 years of age or older with a strong (30 pack-year) smoking history. The current USPSTF and CMS specified eligibility criteria for lung cancer screening are similar to those implemented by the National Lung Screening Trial and other studies which provided the evidence base that precipitated the decision to screen high risk patients, however these criteria may not adequately capture all sub-groups that comprise the complete population at risk for developing lung cancer. For example, younger patients (50+ years) who have a moderate (20 pack-year) smoking history and at least one other known lung cancer-related risk factor are considered to be at high risk by the National Comprehensive Cancer Network (NCCN). The purpose of this investigation is to investigate the prevalence of lung cancer among younger and older age groups of screening patients nationwide and to begin to provide important data that may assist with evaluating the adequacy of the eligibility criteria currently being used to define the population at-risk for developing lung cancer.
Methods:
The Center for Lung Cancer Screening and Prevention at the Stony Brook Cancer Center, recently conducted an electronic survey of all Lung Cancer Alliance Centers of Excellence for Lung Cancer Screening nationwide. The survey collected information regarding numbers and age groups of patients screened, numbers and stages of lung cancers detected, smoking history and other demographic variables. Lung cancer status (cancer detected vs. no cancer detected), stratified by age group (50-54 years vs 55-80 years) are presented here. A total of 24 Centers (among 240) provided data for the survey. Many Centers did not have available data for the younger subgroup of patients likely due to the implementation of the USPSTF criteria rather than the NCCN guidelines that recommend screening this younger, at-risk subgroup.
Results:
The survey data were cumulated over all 24 participating Centers of Excellence nationwide and included 7,252 patients. Of these, n= 697 patients were 50-54 years of age and n=6,555 were 55 years or older. Among the younger cohort, 16 patients (2.3%) were found to have lung cancer. In the older age category, lung cancer was detected in 130 patients or 2.0%.
Conclusion:
These findings suggest that this younger subgroup of at-risk patients warrant further consideration for lung cancer screening. Additionally the data suggest that this well-defined subgroup of 50-54 year old patients who have a moderate smoking history and at least one other known lung cancer-related risk factor may be at even higher risk for developing the disease than those 55+ years with a 30 pack-year smoking history. These nationwide data highlight the urgent need to re-evaluate the eligibility criteria currently being used to define the population at risk for developing lung cancer.
