Initial Outcomes of a Lung Cancer Screening Program in an Integrated Community Health System

J Am Coll Radiol. 2016 Jun;13(6):733-7. doi: 10.1016/j.jacr.2016.02.013. Epub 2016 Apr 28.

Abstract

Purpose: Lung cancer screening with low-dose CT (LDCT) demonstrated reduced mortality in the National Lung Screening Trial, yet there is debate as to whether the reported efficacy can translate into comparable effectiveness with community-based screening. The authors' purpose is to report the baseline patient characteristics and malignancy rate in the first 18 months after implementing a lung cancer screening program in an integrated community health system.

Methods: Patients were screened at 1 of 10 participating community-based centers within a 22-hospital system from 2013 to 2015. LDCT examinations were interpreted by 1 of 20 radiologists using structured reporting and an internally developed tracking system. Manual chart review was performed to ascertain the malignancy detection rate.

Results: A total of 357 patients were screened with LDCT. Of these, 80 patients were ineligible and 3 declined enrollment. The remaining 274 patients satisfied accepted screening criteria and were enrolled in the program. Malignancy was detected in a total of 11 enrollees (4.0%), 8 with lung cancer and 3 with extrapulmonary primary malignancies. Three patients (1.1%) were diagnosed with early-stage lung cancer and received definitive therapy.

Conclusions: Early-stage lung cancer was detected with LDCT screening in an integrated community health system at a rate similar to other trials.

Keywords: LDCT; Lung cancer screening; low-dose CT; lung cancer; lung nodules; pulmonary nodules.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Early Detection of Cancer
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / epidemiology
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Multi-Institutional Systems*
  • Quality Improvement
  • Retrospective Studies
  • Smoking / epidemiology
  • Tomography, X-Ray Computed / methods*
  • Utah / epidemiology