LDCT LUNG SCREENING SAVES LIVES BUT AT A LOW YIELD: ANALYSIS OF LDCT LUNG SCREENING POPULATION AT SEYH 2015-2018

Abstract

SESSION TITLE: Tuesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: To better understand the benefits and disadvantages of LDCT lung screening by analyzing patients who underwent LDCT lung screening at St Elizabeth hospital (SEH) from 2015 to 2018. METHODS: A retrospective study based on questionnaires and screening results that were collected from participants. RESULTS: There were a total of 1,340 person-year participants. There was high all abnormality detection rate (85%). The top three abnormalities were non-calcified nodule or mass > 4 mm (17%), other potentially significant abnormalities above diaphragm (15%) and cardiovascular abnormalities (15%). Based on the quality assurance tool Lung-RADS score, majority of the nodules (78%, 1046/1340) were assigned score of 1 to 3 (negative or benign findings). Among nodules suspicious for malignancy requesting additional diagnostic testing, 5.37% (Lung-RAD 4A, 72 patients) and 1.27% (4B, 17 patients). Among those patients with RADS 4A or 4B, 19 were diagnosed with lung cancer (3 small cell, 4 squamous cell, 12 adenocarcinoma). Based on AJCC tumor staging, lung screening detected mostly stage I (58%) while cancer registry detected mostly stage 4 (44%) cancer. Race, gender, symptoms and risk factor exposure were compared between lung cancer patients and the screening population. There were no significant differences between the two populations. Interestingly, about 60% in both groups reported exposure to second hand smoke, significantly higher than national nonsmoker second hand exposure rate of 25%. The distribution of PPY showed a bimodal distribution in both screening and lung cancer populations. About 68% (13 out of 19) of lung cancer patients had 100 PPY smoking history. However, smoking cessation was not favored by the screening population with only 6.7% (56 out of 830) of current smokers enrolled in a smoking cessation program. It was also striking that 47% (366 out of 774) of current smokers who were not enrolled in a smoking cessation program did not want further information on smoking cessation. CONCLUSIONS: LDCT lung screening detects lung cancer in early stages. However, based on current screening criteria, lung cancer detection rate was very low. A risk stratification model for selecting lung cancer screening candidates is needed. In addition, to reduce lung cancer incidence, smoking cessation remains the most effective method. Better strategies and more aggressive efforts are needed to promote smoking cessation especially in the high-risk groups. CLINICAL IMPLICATIONS: A risk stratification model for selecting lung cancer screening candidates is needed.Better strategies and more aggressive efforts are needed to promote smoking cessation especially in the high-risk groups. DISCLOSURES: No relevant relationships by Timothy Barreiro, source=Web Response No relevant relationships by David Gemmel, source=Web Response No relevant relationships by Yan Jiang, source=Web Response