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: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23495

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    P2.13-026 - Determining the Effect of Screening on Lung Cancer Mortality (ID 9553)

    09:30 - 09:30  |  Author(s): S. Tuminello
    • Abstract

    Background:
    The current lung cancer screening recommendation of the United States Preventive Services Task Force (USPSTF) is to perform annual low-dose computed tomography (CT) scans for high risk current smokers (at least 30 pack-years), or quitters in the past 15 years, age 55-80 years. Our study aims to assess if early detection of lung cancer by screening decreases the lung cancer mortality burden and, if so, how drastically for those considered at highest lung cancer risk.
    
    Method:
    Lung cancer screening prevalence was calculated from the 2010 to 2015 National Health Interview Surveys (NHIS). Probability of screening was derived from logistic regression models using race, age, gender, smoking and health insurance status as predictors. Beta values for these covariates were then used to estimate the probability of screening in the 1999-2004 National Health and Nutrition Examination (NHANES) cohort, for which lung cancer mortality information was available through linkage with the National Death Index. Using the predictor values generated in the NHIS dataset, probability of screening was estimated for the at risk NHANES participants, to make inferences about the effects of screening on lung cancer mortality.
    
    Result:
    Of the 60829 NHIS study participants, 2296 met the definition for being at high for lung cancer. The overall screening prevalence for this at-risk population was 10.4%; 7.7% had chest radiography while 5.7% had CT scans. Screening occurred more frequently in former smokers (p=0.0474), people who had health insurance coverage (p= 0.0017), and those older than 68 years (p = 0.0439). In the NHANES cohort, out of 31126 participants, 668 met the USPSTF recommendation for screening and 25 of them died of lung cancer. Lung cancer mortality was significantly higher in the high-risk group than in the low-risk group (HR~adj~ 8.59, 95% CI: 5.12-14.41). Based on the screening predictors obtained from NHIS data, 347 (51.95%) of the 688 high risk individuals would undergo a screening; 16 of them (4.6%) have died of lung cancer. If screening had occurred, overall lung cancer mortality would have potentially been reduced by 64%, provided that individuals had screening-detected early stage operable tumors.
    
    Conclusion:
    Increasing CT screening among those at high-risk for lung cancer should significantly reduce deaths from lung cancer in this population. Screening needs to be combined with continued smoking cessation efforts.