LDCT lung cancer screening in populations at different risk for lung cancer.

Autor: Teles GBDS; Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil gustavo.teles@einstein.br., Macedo ACS; Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Chate RC; Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Valente VAT; Preventive Health Center, Hospital Israelita Albert Einstein, São Paulo, Brazil., Funari MBG; Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Szarf G; Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: BMJ open respiratory research [BMJ Open Respir Res] 2020 Feb; Vol. 7 (1).
DOI: 10.1136/bmjresp-2019-000455
Abstrakt: Introduction: The improvement of low-dose CT (LDCT) lung cancer screening selection criteria could help to include more individuals who have lung cancer, or in whom lung cancer will develop, while avoiding significant cost increase. We evaluated baseline results of LDCT lung cancer screening in a population with a heterogeneous risk profile for lung cancer.
Methods: LDCT lung cancer screening was implemented alongside a preventive health programme in a private hospital in Brazil. Individuals older than 45 years, smokers and former smokers, regardless of tobacco exposure, were included. Patients were classified according to the National Lung Screening Trial (NLST) eligibility criteria and to PLCO m2012 6-year lung cancer risk. Patient characteristics, CT positivity rate, detection rate of lung cancer and false-positive rate were assessed.
Results: LDCT scans of 472 patients were evaluated and three lung adenocarcinomas were diagnosed. CT positivity rate (Lung-RADS 3/4) was significantly higher (p=0.019) in the NLST group (10.1% (95% CI, 5.9% to 16.9%)) than in the non-NLST group (3.6% (95% CI, 2.62% to 4.83%)) and in the PLCO m2012 high-risk group (14.3% (95% CI, 6.8% to 27.7%)) than in the PLCO m2012 low-risk group (3.7% (95% CI, 2.9% to 4.8%)) (p=0.016). Detection rate of lung cancer was also significantly higher (p=0.018) among PLCO m2012 high-risk patients (5.7% (95% CI, 2.5% to 12.6%)) than in the PLCO m2012 low-risk individuals (0.2% (95% CI, 0.1% to 1.1%)). The false-positive rate for NLST criteria (16.4% (95% CI, 13.2% to 20.1%)) was higher (p<0.001) than for PLCO m2012 criteria (7.6 (95% CI, 5.3% to 10.5%)).
Discussion: Our study indicates a lower performance when screening low-risk individuals in comparison to screening patients meeting NLST criteria and PLCO m2012 high-risk patients. Also, incorporating PLCO m2012 6-year lung cancer risk ≥0.0151 as an eligibility criterion seems to increase lung cancer screening effectiveness.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze: MEDLINE
Externí odkaz: