Abstract
Laryngeal cancer (LC) patients who meet the age and smoking criteria of the U.S. Preventive Services Task Force (USPSTF) for annual CT lung screening were analysed for pulmonary nodules (PN) detection and secondary lung cancer (SLC) diagnosis. This is a retrospective chart review of LC patients treated at Johns Hopkins Hospital from January 2010 to December 2017. The study population included patients who met USPSTF criteria by age and smoking history for annual chest screening and were followed for at least 3 consecutive years. A total of 998 LC patients’ records were reviewed, of which 151 met the inclusion criteria. Inadequate follow-up period (37% of excluded cases) was the most common reason for exclusion, followed by not meeting USPSTF age criteria (27% excluded cases). In seventy-eight patients (n = 78, 52% of analysed patients) PN were reported. Nine individuals (6% of analysed patients) were diagnosed with SLC. Age over 70 (p = 0.003) was an independent predictor of malignancy. White race and smoking history over 40 pack-years were positively associated with a pulmonary nodule detection (p = 0.037 and p = 0.044, respectively). The incidence of PN and SLC in patients with LC is high. Many patients with laryngeal cancer meet the formal guidelines for USPSTF screening, and should be screened annually according to evidence-based medicine for the early detection of secondary lung cancers.
Highlights
13,150 new cases of laryngeal cancer (LC) are diagnosed every year in the USA1
One of the national attempts to reduce the smoking-related mortality was the introduction of the U.S Preventive Services Task Force (USPSTF) recommendations for annual lung cancer screening with low-dose CT in a group of high-risk smokers
The aim of this study was to assess the frequency of incidental findings on CT screening such as pulmonary nodules (PN) and secondary lung cancer (SLC) in a selected group of high-risk Laryngeal cancer (LC) patients meeting the official USPSTF criteria
Summary
13,150 new cases of laryngeal cancer (LC) are diagnosed every year in the USA1. One of the national attempts to reduce the smoking-related mortality was the introduction of the U.S Preventive Services Task Force (USPSTF) recommendations for annual lung cancer screening with low-dose CT in a group of high-risk smokers. This screening program has proven to prevent a significant number of lung cancer–related deaths in patients who received three CT scans over the course of two years. One of the exclusion criterion of the large clinical trials[9] justifying implementation of screening program was previously known malignancy This meant that HNC patients with substantial smoking history and obvious cancer predisposition were excluded. We hypothesized that patients with LC would have findings on lung CT at an equal frequency to smokers without LC, at rate that would justify annual lung CT screening according to evidence-based guidelines
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