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Lung cancer screening intervals based on cancer risk
Li Zhang1, Rowena Yip2, Artit Jirapatnakul2
1Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Lung Cancer (Amsterdam, Netherlands)
|October 2, 2020
Summary
Lung cancer risk factors do not predict cancer aggressiveness. This study found no link between risk indicators and tumor growth rate or stage, suggesting current risk models are insufficient for adjusting screening intervals.
Area of Science:
- Oncology
- Radiology
- Public Health
Background:
- Low-dose CT (LDCT) screening for lung cancer is becoming more common.
- Increasing screening efficiency is a priority, with longer intervals between screenings proposed for lower-risk individuals.
- This study investigated if lower-risk individuals in LDCT screening programs develop less aggressive lung cancers.
Purpose of the Study:
- To determine if lung cancer risk indicators correlate with cancer aggressiveness.
- To assess if risk-based characteristics can inform decisions about adjusting screening intervals.
Main Methods:
- Retrospective analysis of 118 participants from the I-ELCAP database (1992-2019).
- Calculated volume doubling time (VDT) for lung cancers.
- Estimated lung cancer risk using the PLCOM2012 model.
- Assessed the relationship between VDT and risk indicators using correlation coefficients.
Main Results:
- VDT varied significantly by cancer cell type and stage (e.g., adenocarcinoma VDT: 135.7 days; Stage I VDT: 101.4 days).
- No significant correlation was found between established risk indicators (age, smoking history, PLCOM2012 scores) and VDT or cancer stage.
- Lung cancer risk indicators did not predict cancer aggressiveness.
Conclusions:
- Current lung cancer risk models, age, and smoking history do not predict cancer aggressiveness.
- There is no evidence to support using risk-based characteristics for determining intervals between lung cancer screenings.
- Further research may identify future models that can establish such relationships.
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