Impact of lung cancer screening on surgical stage distribution and surgical practice: a regional analysis of patients operated in and out of a screening program.

Autor:	Gooseman MR; Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK., Tentzeris V; Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK., Bulliment KL; Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK., Qadri SSA; Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK., Callister MEJ; Department of Respiratory Medicine, St James's University Hospital, Leeds Teaching Hospitals, Leeds, UK.; School of Medicine, University of Leeds, Leeds, UK., Milton R; Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK., Chaudhuri N; Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK., Tcherveniakov P; Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK., Papagiannopoulos K; Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK., Cowen ME; Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK., Brunelli A; School of Medicine, University of Leeds, Leeds, UK.; Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK.
Jazyk:	angličtina
Zdroj:	Interdisciplinary cardiovascular and thoracic surgery [Interdiscip Cardiovasc Thorac Surg] 2024 Feb 02; Vol. 38 (2).
DOI:	10.1093/icvts/ivad193
Abstrakt:	Objectives: The aim of this study was to assess variations in surgical stage distribution in 2 centres within the same UK region. One centre was covered by an active screening program started in November 2018 and the other was not covered by screening. Methods: Retrospective analysis of 1895 patients undergoing lung resections (2018-2022) in 2 centres. Temporal distribution was tested using Chi-squared for trends. A lowess curve was used to plot the proportion of stage 1A patients amongst those operated over the years. Results: The surgical populations in the 2 centres were similar. In the screening unit (SU), we observed a 18% increase in the proportion of patients with clinical stage IA in the recent phase compared to the early phase (59% vs 50%, P = 0.004), whilst this increase was not seen in the unit without screening. This difference was attributable to an increase of cT1aN0 patients in the SU (16% vs 11%, P = 0.035) which was not observed in the other unit (10% vs 8.2%, P = 0.41). In the SU, there was also a three-fold increase in the proportion of sublobar resections performed in the recent phase compared to the early one (35% vs 12%, P < 0.001). This finding was not evident in the unit without screening. Conclusions: Lung cancer screening is associated with a higher proportion of lung cancers being detected at an earlier stage with a consequent increased practice of sublobar resections. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
Databáze:	MEDLINE
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