LDCT Screening Tied to Lower Incidence of Advanced Lung Cancer

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The use of low-dose computed tomography (LDCT) for lung cancer screening may have led to a significant decrease in advanced lung cancer in the United States, a new study suggests. 

The research was presented at the 2022 ASCO Annual Meeting by Maxwell Akanbi, MD, PhD, of McLaren Flint Hospital in Michigan.

Dr Akanbi explained that, in 2013, the United States Preventive Services Task Force recommended lung cancer screening with LDCT for asymptomatic adults, ages 55 to 80 years, who have a 30 pack-year smoking history and currently smoke or quit smoking within the past 15 years.


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To assess the impact of this recommendation, Dr Akanbi and colleagues calculated the age-adjusted incidence of advanced lung cancer before LDCT screening was covered by insurance for this patient group (2004-2014) and after it was covered (2015-2018).

The researchers analyzed SEER-18 data for 400,343 adults, aged 55 to 80 years, diagnosed with regional or metastatic lung cancer from 2004 to 2018. Slightly more than half of patients were men (54.9%). Most were non-Hispanic White (76.1%) and lived in metropolitan counties (83.7%).

The researchers found a significant decline in the age-adjusted incidence of advanced lung cancer after LDCT screening was adopted. The incidence declined by 3 cases per 100,000 people per year in 2015-2018 relative to 2004-2014 (P <.01).  

There was a significant decrease in advanced lung cancer incidence for both women and men (P <.01 for both), but the decrease was greater for women. 

Non-Hispanic Black patients had the greatest decrease in advanced lung cancer incidence when patients were analyzed by race and ethnicity. The incidence declined by 5 cases per 100,000 people per year for non-Hispanic Black patients, 3 per 100,000 for non-Hispanic White patients, 2 per 100,000 for Hispanic patients, and 2 per 100,000 for non-Hispanic Asian/Pacific Islander patients (P <.01 for all).  

Patients living in non-metropolitan areas had a greater decline in advanced lung cancer incidence when compared with metropolitan dwellers. The incidence declined by 7 cases per 100,000 people per year for non-metropolitan patients and 3 cases per 100,000 for metropolitan patients (P <.01 for both).

“It appears that low-dose cancer screening may be effective in reducing the incidence of advanced lung cancer in the general population without leaving behind minority populations,” Dr Akanbi said. “But the impact on mortality is yet to be determined.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Akanbi MO, Adekolujo OS, Isaac D, et al. Effect of lung cancer screening on the incidence of advanced lung cancer in the United States: A SEER database analysis.  Presented at ASCO 2022; June 3-7, 2022. Abstract 10506.



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