US EPA

6860627 

Journal Article 

Abstract 

Lung cancer screening in the Western Australian Asbestos Review Program 

Harris, E; Murray, C; Franklin, P; Sodhi-Berry, N; Reid, A; Olsen, N; Hall, D; De Klerk, N; Musk, A; Brims, F 

2018 

1 

Respirology
ISSN: 1323-7799
EISSN: 1440-1843 

23(Suppl. 1) 

38 

English 

WOS:000427591800062 

https://doi.org/10.1111/resp.13267
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Introduction
Asbestos exposure increases the risk of lung cancer, especially in smokers. Western Australia (WA) has the highest rates of asbestos-related diseases in the world, due to crocidolite mining in the Pilbara town of Wittenoom and the widespread use of asbestos throughout WA. Early diagnosis utilising low dose CT (LDCT) scans have been shown to reduce mortality from lung cancer.

Aim
To analyse the efficacy of LDCT in detection of lung cancer in an asbestos-exposed population over a 5-year period.

Methods
In 2012, the Asbestos Review Program (based at Sir Charles Gairdner Hospital) began performing annual LDCT to screen an asbestos-exposed population for asbestos related lung disease and lung cancer. Population: Wittenoom miners and residents, other individuals with >3 months cumulative full time exposure. All participants had a prone LDCT scan with annual health questionnaire (including smoking status), spirometry and gas transfer.

Results
5907 LDCT scans were performed on 1760 individuals with a median age of 70 years (IQR 63-76), 1490 (85.1%) were male and 1115 (63.7%) were ever-smokers. Lung cancer was diagnosed in 17 participants (0.97% of the cohort), 15 (pre-operative stage 1a or b) underwent treatment with curative intent, 2 underwent non-curative chemo-radiation. Lung cancer was prevalent in 10 (59%), and incident in 7 (41%) individuals (see Table 1). One participant died 4 months after surgery (found to have M1a disease during operation); no participants treated curatively have had reoccurrence to date. Mesothelioma was diagnosed in 7 other individuals. Asbestosis was present in 40.3% of the ARP population and 64.0% had pleural plaques, confirming significant asbestos exposure. The median radiation exposure per LDCT was 0.20mSv (IQR 0.14-0.52).

Conclusions
A carefully controlled LDCT screening program is effective at diagnosing and treating early-stage lung cancer in this population. Occupational exposure to asbestos should be accounted for in assessing risk for lung cancer. 

The Australia & New Zealand Society of Respiratory Science and The Thoracic Society of Australia and New Zealand (ANZSRS/TSANZ) Annual Scientific Meeting 

Adelaide, Australia 

March 23–27, 2018