Experience with a CT screening program for individuals at high risk for developing lung cancer

Area of Science:

• Radiology
• Oncology
• Public Health

Background:

• The National Comprehensive Cancer Network (NCCN) categorizes individuals into risk groups for lung cancer screening.
• High-risk group 1 is currently the standard for CT lung screening eligibility.
• Group 2 represents an additional high-risk population not routinely included in screening programs.

Purpose of the Study:

• To compare the outcomes of CT lung screening between NCCN high-risk group 2 and group 1.
• To evaluate the potential benefits of expanding screening eligibility to include NCCN group 2.

Main Methods:

• Retrospective review of 1,760 consecutive CT lung screening examinations from January 2012 to December 2013.
• Interpretation followed NCCN guidelines, with positive results defined by nodule size or lymph node criteria.
• Incidental findings and signs of pulmonary infection were also recorded.

Main Results:

• 1,760 examinations were analyzed; 464 in group 2 and 1,296 in group 1.
• Positive findings, significant incidental findings, and suspected infections were similar across both groups (25% vs 28.2%, 6% vs 6.2%, 6% vs 6.6%, respectively).
• Annualized lung cancer diagnosis rates were comparable: 1.8% in group 2 and 1.6% in group 1.

Conclusions:

• NCCN group 2 demonstrated results similar to group 1 and the National Lung Screening Trial.
• The comparable positivity and cancer detection rates support expanding CT lung screening eligibility.
• Inclusion of NCCN group 2 could lead to significant increases in lives saved through early lung cancer detection.