Yield of Low-Dose Computerized Tomography Screening for Lung Cancer in High-Risk Workers: The Case of 7189 US Nuclear
Steven B Markowitz1, Amy Manowitz1, Jeffery A Miller1
1Steven B. Markowitz, Amy Manowitz, Amaka C. Onyekelu-Eze, Lewis D. Pepper, and Albert Miller are with Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Flushing, NY. Jeffrey A. Miller is with the Department of Veterans Affairs New Jersey Health Care System East Orange Campus, Department of Radiology, East Orange. James S. Frederick is with United Steelworkers, Health, Safety, and Environment Department, Pittsburgh, PA. Shannon A. Widman is with Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC.
Objectives:
To determine the lung cancer screening yield and stages in a union-sponsored low-dose computerized tomography scan program for nuclear weapons workers with diverse ages, smoking histories, and occupations.
Methods:
We implemented a low-dose computerized tomography program among 7189 nuclear weapons workers in 9 nonmetropolitan US communities during 2000 to 2013. Eligibility criteria included age, smoking, occupation, radiographic asbestos-related fibrosis, and a positive beryllium lymphocyte proliferation test.
Results:
The proportion with screen-detected lung cancer among smokers aged 50 years or older was 0.83% at baseline and 0.51% on annual scan. Of 80 lung cancers, 59% (n = 47) were stage I, and 10% (n = 8) were stage II. Screening yields of study subpopulations who met the National Lung Screening Trial or the National Comprehensive Cancer Network Group 2 eligibility criteria were similar to those found in the National Lung Screening Trial.
Conclusions:
Computerized tomography screening for lung cancer among high-risk workers leads to a favorable yield of early-stage lung cancers. Public Health Implications. Health equity and efficiency dictate that screening high-risk workers for lung cancer should be an important public health priority.
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