Experience With a CT Screening Program for Individuals at High Risk for Developing Lung Cancer

Area of Science:

• Pulmonology
• Oncology
• Radiology

Background:

• Lung cancer screening guidelines, such as those from the National Comprehensive Cancer Network (NCCN), define high-risk groups for eligibility.
• NCCN categorizes individuals into different risk groups based on factors like smoking history and age.
• Evaluating the effectiveness of screening across different NCCN-defined risk groups is crucial for optimizing lung cancer detection.

Purpose of the Study:

• To compare the outcomes of clinical CT lung screening between NCCN high-risk group 2 and NCCN high-risk group 1.
• To assess the rates of positive screening results, incidental findings, and lung cancer diagnosis in these two groups.

Main Methods:

• Retrospective review of 1,760 consecutive CT lung screening examinations from January 2012 to December 2013.
• Interpretation of scans by credentialed radiologists following NCCN guidelines (version 1.2012).
• Defined positive results based on nodule size, lymph node size, or stability over time; also recorded incidental findings and signs of infection.

Main Results:

• No significant differences in positive screening results (25% in group 2 vs. 28.2% in group 1), clinically significant incidental findings (6% vs. 6.2%), or suspected pulmonary infection (6% vs. 6.6%).
• Lung cancer was diagnosed in 6 cases in group 2 and 17 cases in group 1, yielding similar annualized malignancy rates (1.8% in group 2 vs. 1.6% in group 1).

Conclusions:

• Outcomes for NCCN high-risk group 2 were comparable to those for NCCN high-risk group 1.
• These findings align with results from the National Lung Screening Trial.
• Expanding lung cancer screening eligibility to include NCCN group 2 could potentially increase the number of lives saved annually.