Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2022
Lung cancer screening with low-dose CT integrated with pulmonary care in a public hospital in southern Brazil: results from the first 712 patients.
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Svartman Fábio Munhoz, Leite Maurício Mello Roux, Sartori Ana Paula Garcia, Gutierrez Renato Soares, Cadore Ana Carolina, Oliveira Carla Tatiana Martins de, Brito Renata Ullmann de, Andrade Cristiano Feijó
Аннотация
OBJECTIVE: To describe the performance of a pulmonologist-led lung cancer screening program using low dose CT (LDCT) in a cohort of outpatients with stable respiratory diseases in the Brazilian public health care system.
METHODS: This was a retrospective analysis of the first two rounds of lung cancer screening of patients enrolled in the program. Inclusion criteria were being between 55 and 80 years of age, being a current or former smoker (smoking cessation ≤ 15 years), and having a smoking history ≥ 30 pack-years. LDCT results were interpreted in accordance with the Lung CT Screening Reporting and Data System, and those with a score of 3 or 4 were considered positive screening. Incidental pleuropulmonary findings were sought in all reports.
RESULTS: LDCTs were requested for 791 patients during the study period, and 712 patients (90%) met the screening criteria. The mean patient age was 63 years, and most participants were current smokers (56%) with emphysema (78.5%) and other pleuropulmonary findings on CT (64%). Screening was positive in 14.0% and 5.6% of the cases in the first and second screening rounds, respectively. Lung cancer was detected in 1.5% of the patients in both first and second rounds (positive predictive value: 11.0% and 26.6%, respectively). The rate of early-stage (TNM I or II) screen-detected non-small cell carcinoma was 64.3%. Of the patients with positive screening, 19% were lost to follow-up before investigation was complete.
CONCLUSIONS: The results of this screening program suggest its adequate performance in a cohort of patients with significant respiratory morbidity. The loss to follow-up rate highlights the need for constant monitoring and interventions to ensure adherence.
METHODS: This was a retrospective analysis of the first two rounds of lung cancer screening of patients enrolled in the program. Inclusion criteria were being between 55 and 80 years of age, being a current or former smoker (smoking cessation ≤ 15 years), and having a smoking history ≥ 30 pack-years. LDCT results were interpreted in accordance with the Lung CT Screening Reporting and Data System, and those with a score of 3 or 4 were considered positive screening. Incidental pleuropulmonary findings were sought in all reports.
RESULTS: LDCTs were requested for 791 patients during the study period, and 712 patients (90%) met the screening criteria. The mean patient age was 63 years, and most participants were current smokers (56%) with emphysema (78.5%) and other pleuropulmonary findings on CT (64%). Screening was positive in 14.0% and 5.6% of the cases in the first and second screening rounds, respectively. Lung cancer was detected in 1.5% of the patients in both first and second rounds (positive predictive value: 11.0% and 26.6%, respectively). The rate of early-stage (TNM I or II) screen-detected non-small cell carcinoma was 64.3%. Of the patients with positive screening, 19% were lost to follow-up before investigation was complete.
CONCLUSIONS: The results of this screening program suggest its adequate performance in a cohort of patients with significant respiratory morbidity. The loss to follow-up rate highlights the need for constant monitoring and interventions to ensure adherence.