Using Low-Dose Computed Tomography for Early Detection of Lung Cancer

To determine whether low-dose computed tomography (LD-CT) affects the rate of early lung cancer detection in a high-risk population, how that rate compares with the rate given in the National Lung Screening Trial (NLST), whether using LD-CT provides a stage shift in lung cancer, and whether NLST results are reproducible.

Patient medical records from a Kentucky community hospital were retrospectively reviewed. Patients who were included had received LD-CT scans from January 2015 through December 2017, were aged 55 years to 79 years, had smoked for at least 30 pack-years or quit smoking in the past 15 years and were able to lie on their backs with their arms over their heads. Patients with any previous cancer were excluded. Retrospective chart review employed to collect data, and summarized quantitative data were used as measures of central tendency (ie, mean and mode).

The study included 2924 patients, with 1483 men (50.7%) and 1441 women (49.3%). Sixty-six patients (42 men, 24 women) had lung cancer, all of whom smoked a maximum of 3.5 packs of cigarettes a day. Of the 66 patients, 7 patients (10.6%) died during the 3-year study timeframe. The study found an average of 2 cancer diagnoses per 100 LD-CT scans, whereas the NLST noted 1 diagnosis for every 320 scans. Mortality rate was associated with lung cancer in this high-risk population, calculated at 239 per 100 000 patients.

Compared with NLST findings, this current study found that lung cancer is diagnosed in Kentucky residents at a higher rate, and that this group is at greater risk for developing smoking-related lung cancer. In addition, LD-CT is useful in early lung cancer detection for asymptomatic, high-risk populations and can improve quality of life, prolong life, and reduce overall health care costs.

Lung cancer is a public health care problem in the United States and specifically in Kentucky. This situation might improve if legislation prioritizes educating the medical community about the tools available for early detection of lung cancer, including LD-CT.