Estimating lung cancer risk from chest X-ray and symptoms: a prospective cohort study
| Autor: | Stephen H Bradley, Matthew E.J. Callister, Nathaniel Luke Fielding Hatton, Luke T. A. Mounce, Bobby Bhartia, Martyn P.T. Kennedy, William Hamilton, Bethany Shinkins, Richard D Neal, Rehima Aslam |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Lung Neoplasms Urgent referral Radiography Population Primary care Disease Sensitivity and Specificity chest x-ray primary care 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Prospective Studies 030212 general & internal medicine Lung cancer education Prospective cohort study Lung general practice education.field_of_study business.industry Research X-Rays medicine.disease Predictive value radiograph lung cancer 030220 oncology & carcinogenesis Radiography Thoracic Family Practice business early diagnosis |
| Zdroj: | The British Journal of General Practice |
| ISSN: | 1478-5242 0960-1643 |
| DOI: | 10.3399/bjgp20x713993 |
| Popis: | BackgroundChest X-ray (CXR) is the first-line investigation for lung cancer in many countries but previous research has suggested that the disease is not detected by CXR in approximately 20% of patients. The risk of lung cancer, with particular symptoms, following a negative CXR is not known.AimTo establish the sensitivity and specificity of CXR requested by patients who are symptomatic; determine the positive predictive values (PPVs) of each presenting symptom of lung cancer following a negative CXR; and determine whether symptoms associated with lung cancer are different in those who had a positive CXR result compared with those who had a negative CXR result.Design and settingA prospective cohort study was conducted in Leeds, UK, based on routinely collected data from a service that allowed patients with symptoms of lung cancer to request CXR.MethodSymptom data were combined with a diagnostic category (positive or negative) for each CXR, and the sensitivity and specificity of CXR for lung cancer were calculated. The PPV of lung cancer associated with each symptom or combination of symptoms was estimated for those patients with a negative CXR.ResultsIn total, 114 (1.3%) of 8996 patients who requested a CXR were diagnosed with lung cancer within 1 year. Sensitivity was 75.4% and specificity was 90.2%. The PPV of all symptoms for a diagnosis of lung cancer within 1 year of CXR was ConclusionCXR has limited sensitivity; however, in a population with a low prevalence of lung cancer, its high specificity and negative predictive value means that lung cancer is very unlikely to be present following a negative result. Findings also support guidance that unexplained haemoptysis warrants urgent referral, regardless of CXR result. |
| Databáze: | OpenAIRE |
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