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Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
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Adherence to Posttreatment Surveillance Guidelines in Non-Small Cell Lung Cancer: Retrospective Cohort Study
Ryan J Randle1, Scott V Adams2, Zahra Esfahanimonfared1
1Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford Medicine, 870 Quarry Rd, Stanford, CA, 94305, United States, 1 (650) 723-5771.
JMIR Cancer
|October 1, 2025
Summary
Posttreatment surveillance for non-small cell lung cancer (NSCLC) is recommended, but true rates are lower than previously reported. More strategies are needed to ensure guideline-concordant care for lung cancer survivors.
Area of Science:
- Oncology
- Medical Imaging
- Public Health
Background:
- Guidelines recommend posttreatment surveillance for non-small cell lung cancer (NSCLC).
- Previous studies struggled to differentiate surveillance imaging from imaging for recurrence symptoms.
- Competing events and variability in clinical practice complicate true surveillance rate determination.
Purpose of the Study:
- To estimate true rates of posttreatment surveillance for early-stage NSCLC.
- To identify predictors of guideline-concordant care in NSCLC survivors.
- To utilize a novel competing risks framework for accurate surveillance pattern analysis.
Main Methods:
- A cohort of 1888 veterans treated for stage 1-3 NSCLC (2008-2016) was analyzed.
- A competing risks framework was applied to estimate cumulative surveillance probability.
- Multivariable Cox regression identified patient factors associated with guideline-concordant surveillance.
Main Results:
- Guideline-concordant surveillance (CT scan 4-9 months post-treatment) was lower than previously reported.
- Chest CT was the most common imaging modality (44.5%).
- Patients treated later (2014-2016) showed a higher likelihood of guideline-concordant surveillance (HR 1.42, P<.001).
Conclusions:
- A significant gap exists in guideline-concordant surveillance for eligible NSCLC survivors.
- The competing risks framework provides a more accurate assessment of surveillance rates.
- Enhanced strategies, education, and advocacy are crucial for improving NSCLC surveillance adherence.
