CT screening for lung cancer: Comparison of three baseline screening protocols Journal Article


Authors: Henschke, C. I.; Yip, R.; Ma, T.; Aguayo, S. M.; Zulueta, J.; Yankelevitz, D. F.; Writing Committee for the I-ELCAP Investigators
Contributors: Heelan, R. T.; Ginsberg, M. S.
Article Title: CT screening for lung cancer: Comparison of three baseline screening protocols
Abstract: Purpose Clinical management decisions arising from the baseline round for lung cancer screening are the most challenging, as findings have accumulated over a lifetime and may be of no clinical concern. To minimize unnecessary harms and costs of workup prior to the first, annual repeat screening, workup should be limited to participants with the highest suspicion of lung cancer while still aiming to identify small, early lung cancers. Methods We compared recommendations for immediate, delayed (by 3 or 6 months) workup to assess growth at a malignant rate, and the resulting overall and potential biopsies of three baseline screening protocols: I-ELCAP, the two scenarios of ACR-LungRADS, and the European Consortium. For each protocol, the efficiency ratio (ER) of each recommendation was calculated by dividing the number of participants recommended for that workup by the number of resulting lung cancer diagnoses. The ER for potential biopsies was calculated, assuming that biopsies were performed on all participants recommended for immediate workup as well as those diagnosed with lung cancer after delayed workup. Results For I-ELCAP, ACR-LungRADS Scenario 1, ACR-LungRADS Scenario 2, and the European consortium, the overall ER was 13.9, 18.3, 18.3, and 31.9, respectively, and for potential biopsies, it was 2.2, 8.1, 3.2, and 4.4, respectively. ER for immediate workup was 2.9, 8.6, 3.9, and 5.6, respectively, and for delayed workup was 36.1, 160.3, 57.8, and 111.9, respectively. Conclusions I-ELCAP recommendations had the lowest ER values for overall, immediate, and delayed workup, and for potential biopsies.
Keywords: lung neoplasms; cancer screening; tomography; trial; computed-tomography; program; clinical; nodules; action project; protocols; positive test result; spiral computed
Journal Title: European Radiology
Volume: 29
Issue: 10
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2019-10-01
Start Page: 5217
End Page: 5226
Language: English
ACCESSION: WOS:000483696900010
DOI: 10.1007/s00330-018-5857-5
PROVIDER: wos
PUBMED: 30511179
Notes: Erratum issued, see DOI: 10.1007/s00330-018-5983-0 -- Source: Wos
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  1. Michelle S Ginsberg
    235 Ginsberg
  2. Robert T Heelan
    140 Heelan