The decision to biopsy in a lung cancer screening program: Potential impact of risk calculators
| Autor: | Christopher R. Gilbert, Adam J. Bograd, Jed A. Gorden, Alexander S. Carlson, Ralph W. Aye, Candice L. Wilshire, Alexander S. Farivar |
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| Rok vydání: | 2018 |
| Předmět: |
Oncology
Male medicine.medical_specialty Lung Neoplasms Biopsy Decision Making Risk Assessment 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine Medicine Humans Mass Screening 030212 general & internal medicine Lung Aged Retrospective Studies Potential impact medicine.diagnostic_test business.industry Health Policy Public Health Environmental and Occupational Health Middle Aged 030220 oncology & carcinogenesis National Lung Screening Trial Female High incidence business Lung cancer screening |
| Zdroj: | Journal of medical screening. 26(1) |
| ISSN: | 1475-5793 |
| Popis: | Objective The National Lung Screening Trial demonstrated the benefits of lung cancer screening, but the potential high incidence of unnecessary invasive testing for ultimately benign radiologic findings causes concern. We aimed to review current biopsy patterns and outcomes in our community-based program, and retrospectively apply malignancy prediction models in a lung cancer screening population, to identify the potential impact these calculators could have on biopsy decisions. Methods Retrospective review of lung cancer-screening program participants from 2013 to 2016. Demographic, biopsy, and outcome data were collected. Malignancy risk calculators were retrospectively applied and results compared in patients with positive imaging findings. Results From 520 individuals enrolled in the screening program, pulmonary nodule(s) ≥6 mm were identified in 166, with biopsy in 30. Malignancy risk probabilities were significantly higher (Brock p Conclusions In our screening program, 5.7% of individuals undergo invasive testing, comparable with the National Lung Screening Trial (6.1%). Both Brock and Mayo calculators perform well in indicating who may be at risk of malignancy, based on clinical and radiologic factors. However, in our invasive testing group, the Brock and Mayo calculators and Lung Cancer Screening Program clinical assessment all lacked clarity in distinguishing individuals who have a cancer from those with a benign abnormality. |
| Databáze: | OpenAIRE |
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