Changes in Staging and Management of Non-Small Cell Lung Cancer (NSCLC) Patients Following the Implementation of Low-Dose Chest Computed Tomography (LDCT) Screening at Kaohsiung Medical University Hospital

Chin-Ling Chen ^1,2, Jui-Sheng Hsu ³, Yi-Wen Shen ¹

¹Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
²Department of Nursing, Kaohsiung Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
³Department of Radiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
⁴Department of Pathology, Kaohsiung Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
⁵Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
⁶Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
⁷Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
⁸Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
⁹School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.

⁰Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.

Cancers +

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November 27, 2024

View abstract on PubMed

Summary

Low-dose computed tomography (LDCT) significantly increases early-stage lung cancer detection, especially adenocarcinoma, improving survival rates. However, it shows limited impact on reducing late-stage diagnoses for other subtypes.

Area Of Science

Pulmonology
Oncology
Radiology

Background

Low-dose computed tomography (LDCT) is established for lung cancer screening in high-risk individuals.
LDCT has demonstrated efficacy in reducing lung cancer mortality.

Purpose Of The Study

To evaluate the impact of LDCT screening on non-small cell lung cancer (NSCLC) staging.
To analyze the correlation between LDCT screening volume and NSCLC stage distribution.
To assess the effect of early detection on survival rates and histopathological subtypes.

Main Methods

Retrospective study analyzing data from 2011-2020.
Examined changes in NSCLC stage distribution post-LDCT introduction in 2013.
Correlated LDCT screening volume with early (0, I) and late (IV) stage diagnoses.
Assessed histopathological subtypes (adenocarcinoma, squamous cell carcinoma) and five-year survival rates.

Main Results

Significant increase in early-stage NSCLC diagnoses, particularly adenocarcinoma (10.4% to 38.7%).
Stable number of stage IV cases observed, suggesting limited impact on late-stage diagnoses.
Strong positive correlation between LDCT screening and early-stage adenocarcinoma detection (p < 0.001).
Limited improvement in early detection for squamous cell carcinoma and small cell carcinoma.

Conclusions

LDCT screening is vital for enhancing early NSCLC detection and improving five-year survival.
Further research is needed to optimize screening for diverse populations and challenging subtypes.
Strategies to improve detection of squamous cell carcinoma warrant further investigation.

Keywords:

LDCT adenocarcinoma early detection five-year survival low-dose computed tomography lung cancer staging non-small cell lung cancer squamous cell carcinoma