Author of

• 20177

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  P2.13 - Radiology/Staging/Screening (ID 714)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Radiology/Staging/Screening
  • Presentations: 2
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23480

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    P2.13-011 - Optimal Selection Criteria for LDCT Lung Cancer Screening (ID 9628)

    09:30 - 09:30  |  Author(s): J. Liu
    • Abstract

    Background:
    Lung cancer screening programs with low dose computed tomography (LDCT) could be economically viable if they targeted high-risk people. The optimal selection criteria have not been defined in prospective clinical trials. The goal of this prospective study is to test the hypothesis that lung cancer screening based on a highly predictive risk model: The Prostate, Lung, Colon, Ovarian (PLCO~m2012~) is superior to applying National Lung Screening Trial (NLST)-like criteria.
    
    Method:
    Participants were enrolled through three screening studies, two in Canada (Vancouver and Alberta) and one in London, UK. Eligibility included a PLCOm2012 6-year lung cancer risk ≥1.5% or NLST-like criteria (≥30 pack-years smoking history and quit ≤15 years with some variation in age limits – 55 to 80 years in BC, 55 to 74 in Alberta and 60 to 75 in UCL). The proportion of participants who have been found to have lung cancer or high risk lung nodules, requiring repeat imaging studies or biopsy prior to the next scheduled annual screening were compared between the two selection methods.
    
    Result:
    The demographics of participants are shown in Table 1. To date, 1,533 received a LDCT, of these, 341 met the PLCOm2012 criteria alone, 169 met NLST-like criteria and 1023 met both criteria. Twenty-seven participants have been found to have lung cancers. All 27 met the PLCOm2012 selection criteria alone while 62% met NLST- like criteria. No lung cancer was found in participants who met NLST-like criteria alone. There are 129 participants with suspicious lung nodules under close surveillance or scheduled for biopsy. Among these, 97% met the PLCOm2012 criteria and 74% met NLST-like criteria.

    Table 1. Clinical and Demographic Features of Study Cohorts

    Study Site	British Columbia	Alberta	London	Total
    No. Contacted	802	1661	1990	4453
    No. Eligible	364	741	812	1917
    No. Screened	241	688	604	1533
    Age (yrs)	65+/- 6.3	63.5 +/- 4.2	66+/-4.2	64.8+/- 5.7
    Sex (female/Male)	91F:150M	342F:346M	273F:331M	706M;827M
    Current:Former Smoker	103CS:138Ex	341CS:347Ex	443CS:161Ex	887CS:646Ex
    Pack Years (Mean +/-SD)	47.3+/-22	42.4+/-15.8	47.7+/-22.3	45.3+/-19.8
    Median Follow-up(months)	7.5	9.7	9.7
    No. of lung Cancers	3	7	17	27
    Participants with suspicios nodules	21	41	67	129

    
    
    Conclusion:
    Our preliminary results show that fewer people are eligible for screening using NLST-like criteria compare to a highly predictive risk model such as PLCOm2012. Thirty-seven percent more participants with lung cancer are identified by PLCOm2012.
    
    

  • 23481

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    P2.13-012 - Recruitment for Lung Cancer Screening (ID 9673)

    09:30 - 09:30  |  Author(s): J. Liu
    • Abstract

    Background:
    The efficiency of a lung cancer screening program with low dose computed tomography (LDCT) is influenced by the screening uptake. The most efficient method to improve participation rate of individuals in the general population who are eligible for screening has not been determined. We evaluated different methods of recruitment on the participation rate.
    
    Method:
    The BC lung screening trial is part of the International Lung Screen Trial (ILST) in Canada, Australia, the UK and Hong Kong. ILST aims at defining the optimal selection criteria for LDCT by comparing the relative sensitivity of the US Preventative Services Task Force criteria versus the PLCOm2012 prediction model with 6-year lung cancer risk>=1.5%. Individuals with a chest CT within 2 years are excluded from the screening study. Different methods [social media, radio, newspaper, QuitNow smoking cessation program, BC Lung Association and referrals by general practitioners (GP)] to recruit eligible individuals are compared.
    
    Result:
    Of the 802 participants referred or self-referred to the study, 364 (41% female, 59% males, 53% ex-smokers and 47% current smokers) were eligible. The largest draw was radio which reached 64% of respondents, however only 29% of these were eligible. General practitioners (GP) reached only 24% but of these 70 % were eligible. 13% had a CT scan within 2 years, and but only 40% would have been eligible via risk criteria (Table 1). Table1. Figure 1
    
    
    
    Conclusion:
    The largest number of eligible participants were referred by their GPs. Media (radio) reached a larger number of participants but many were ineligible. A combined approach of media publicity and GP referrals may be the best way to reach the target the population. Ad hoc screening is likely occurring in the absence of a publicly funded screening program inappropriately exposing participants outside of the criteria.