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HERO ID
2247960
Reference Type
Journal Article
Title
CT scan screening for lung cancer: risk factors for nodules and malignancy in a high-risk urban cohort
Author(s)
Greenberg, AK; Lu, F; Goldberg, JD; Eylers, E; Tsay, JC; Yie, TA; Naidich, D; Mcguinness, G; Pass, H; Tchou-Wong, KM; Addrizzo-Harris, D; Chachoua, A; Crawford, B; Rom, WN
Year
2012
Is Peer Reviewed?
1
Journal
PLoS ONE
EISSN:
1932-6203
Publisher
PUBLIC LIBRARY SCIENCE
Location
SAN FRANCISCO
Volume
7
Issue
7
Page Numbers
e39403
Language
English
PMID
22768300
DOI
10.1371/journal.pone.0039403
Web of Science Id
WOS:000305966500013
Abstract
BACKGROUND:
Low-dose computed tomography (CT) for lung cancer screening can reduce lung cancer mortality. The National Lung Screening Trial reported a 20% reduction in lung cancer mortality in high-risk smokers. However, CT scanning is extremely sensitive and detects non-calcified nodules (NCNs) in 24-50% of subjects, suggesting an unacceptably high false-positive rate. We hypothesized that by reviewing demographic, clinical and nodule characteristics, we could identify risk factors associated with the presence of nodules on screening CT, and with the probability that a NCN was malignant.
METHODS:
We performed a longitudinal lung cancer biomarker discovery trial (NYU LCBC) that included low-dose CT-screening of high-risk individuals over 50 years of age, with more than 20 pack-year smoking histories, living in an urban setting, and with a potential for asbestos exposure. We used case-control studies to identify risk factors associated with the presence of nodules (n=625) versus no nodules (n=557), and lung cancer patients (n=30) versus benign nodules (n=128).
RESULTS:
The NYU LCBC followed 1182 study subjects prospectively over a 10-year period. We found 52% to have NCNs >4 mm on their baseline screen. Most of the nodules were stable, and 9.7% of solid and 26.2% of sub-solid nodules resolved. We diagnosed 30 lung cancers, 26 stage I. Three patients had synchronous primary lung cancers or multifocal disease. Thus, there were 33 lung cancers: 10 incident, and 23 prevalent. A sub-group of the prevalent group were stable for a prolonged period prior to diagnosis. These were all stage I at diagnosis and 12/13 were adenocarcinomas.
CONCLUSIONS:
NCNs are common among CT-screened high-risk subjects and can often be managed conservatively. Risk factors for malignancy included increasing age, size and number of nodules, reduced FEV1 and FVC, and increased pack-years smoking. A sub-group of screen-detected cancers are slow-growing and may contribute to over-diagnosis and lead-time biases.
Tags
IRIS
•
Libby Amphibole Asbestos (Draft, 2011)
Pulmonary Function Search, Sept 2013
Database Search
Excluded Based on Title/Abstract Screening
Did not examine study question
OPPT REs
•
OPPT_Asbestos, Part I: Chrysotile_F. Human Health
Total – title/abstract screening
Off topic
•
OPPT_Asbestos, Part I: Chrysotile_Supplemental Search
LitSearch: Sept 2020 (Undated)
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