Outcomes From More Than 1 Million People Screened for Lung Cancer With Low-Dose CT Imaging

Area of Science:

• Pulmonology
• Oncology
• Radiology

Background:

• Low-dose CT (LDCT) for lung cancer screening (LCS) became recommended in 2013, making millions eligible.
• Population-level data on demographics and outcomes for LCS in the US were previously lacking.

Purpose of the Study:

• To compare outcomes of individuals undergoing LCS in the American College of Radiology's Lung Cancer Screening Registry with trial participants.
• To identify predictors of adherence to annual LCS.

Main Methods:

• A cohort study analyzed baseline LDCT scans for LCS from 2015-2019.
• Lung-RADS scores, cancer detection rates (CDRs), and stage at diagnosis were compared with National Lung Cancer Screening Trial data.
• Predictors of adherence to annual screening were computed.

Main Results:

• Adherence to annual LCS was low at 22.3%, with current smoking and minority race predicting poor adherence.
• 17% of baseline screenings were positive, with higher Lung-RADS categories correlating with increased cancer detection.
• Cancer stage distribution was similar to the National Lung Cancer Screening Trial, with 53.5% diagnosed at stage I.

Conclusions:

• LDCT imaging accurately correlates with lung cancer detection via the Lung-RADS system.
• A shift towards early-stage lung cancer detection was observed.
• Poor adherence to LCS is a significant challenge impacting cancer detection rates and patient outcomes.