Resected lung cancer patients who would and would not have met screening criteria Journal Article


Authors: Farjah, F.; Wood, D. E.; Zadworny, M. E.; Rusch, V. W.; Rizk, N. P.
Article Title: Resected lung cancer patients who would and would not have met screening criteria
Abstract: Background Current eligibility criteria for lung cancer screening may underestimate the risk of malignancy for some individuals. We compared the predicted risk of lung cancer among patients who would have met screening criteria to those who would not have despite being at moderate-risk. Methods A retrospective cohort study of resected lung cancer patients was performed. The screen eligible group was based on criteria provided by the United States Preventive Services Task Force; age 55 to 80 and a 30 or greater pack-year smoking history. The screen ineligible group was based on criteria provided by the National Comprehensive Cancer Network for a moderate-risk individual not recommended screening; age greater than 50 years, greater than 20 pack-year smoking history, and no history of asbestos exposure or chronic obstructive pulmonary disease. A recently validated risk-prediction model was used to compare the risk of lung cancer across eligibility groups based on measured and imputed patient-level variables. Results Screen ineligible patients (n = 88) had a lower estimated probability of lung cancer than screen eligible patients (n = 419); 1.3% versus 3.1%, p value less than 0.001. However, 20% of screen ineligible patients had a predicted probability of lung cancer greater than or equal to the prevalence of lung cancer (3.7%) among National Lung Screening Trial participants; 17% of screen ineligible patients had a predicted probability of lung cancer greater than or equal to the American Association for Thoracic Surgery threshold (5%) defining high-risk individuals. Conclusions Current eligibility criteria for lung cancer screening underestimate the risk of lung cancer for some individuals who might benefit from lung cancer screening. © 2016 The Society of Thoracic Surgeons.
Keywords: adult; aged; cancer surgery; major clinical study; cancer risk; cancer patient; lung resection; prevalence; cancer screening; lung cancer; smoking; retrospective study; probability; medical society; environmental exposure; chronic obstructive lung disease; asbestos; human; male; female; priority journal; article
Journal Title: Annals of Thoracic Surgery
Volume: 101
Issue: 1
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2016-01-01
Start Page: 274
End Page: 279
Language: English
DOI: 10.1016/j.athoracsur.2015.06.010
PROVIDER: scopus
PMCID: PMC4755482
PUBMED: 26298169
DOI/URL:
Notes: Article -- Export Date: 3 March 2016 -- Source: Scopus
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  1. Valerie W Rusch
    864 Rusch
  2. Nabil Rizk
    139 Rizk