Baseline and annual repeat rounds of screening: implications for optimal regimens of screening

International Early Lung Cancer Action Program Investigators

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: Differences in results of baseline and subsequent annual repeat rounds provide important information for optimising the regimen of screening. Methods: A prospective cohort study of 65,374 was reviewed to examine the frequency/percentages of the largest noncalcified nodule (NCN), lung cancer cell types and Kaplan–Meier (K-M) survival rates, separately for baseline and annual rounds. Results: Of 65,374 baseline screenings, NCNs were identified in 28,279 (43.3%); lung cancer in 737 (1.1%). Of 74,482 annual repeat screenings, new NCNs were identified in 4959 (7%); lung cancer in 179 (0.24%). Only adenocarcinoma was diagnosed in subsolid NCNs. Percentages of lung cancers by cell type were significantly different (p < 0.0001) in the baseline round compared with annual rounds, reflecting length bias, as were the ratios, reflecting lead times. Long-term K-M survival rate was 100% for typical carcinoids and for adenocarcinomas manifesting as subsolid NCNs; 85% (95% CI 81–89%) for adenocarcinoma, 74% (95% CI 63–85%) for squamous cell, 48% (95% CI 34–62%) for small cell. The rank ordering by lead time was the same as the rank ordering by survival rates. Conclusions: The significant differences in the frequency of NCNs and frequency and aggressiveness of diagnosed cancers in baseline and annual repeat need to be recognised for an optimal regimen of screening. Key Points: • Lung cancer aggressiveness varies considerably by cell type and nodule consistency. • Kaplan–Meier survival rates varied by cell type between 100% and 48%. • The percentages of lung cancers by cell type in screening rounds reflect screening biases. • Rank ordering by cell type survival is consistent with that by lead times. • Empirical evidence provides critical information for the regimen of screening.

Original languageEnglish (US)
Pages (from-to)1085-1094
Number of pages10
JournalEuropean Radiology
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2018

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Lung Neoplasms
Adenocarcinoma
Cell Survival
Carcinoid Tumor
Cohort Studies
Epithelial Cells
Prospective Studies
Neoplasms

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

International Early Lung Cancer Action Program Investigators. / Baseline and annual repeat rounds of screening : implications for optimal regimens of screening. In: European Radiology. 2018 ; Vol. 28, No. 3. pp. 1085-1094.
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abstract = "Objectives: Differences in results of baseline and subsequent annual repeat rounds provide important information for optimising the regimen of screening. Methods: A prospective cohort study of 65,374 was reviewed to examine the frequency/percentages of the largest noncalcified nodule (NCN), lung cancer cell types and Kaplan–Meier (K-M) survival rates, separately for baseline and annual rounds. Results: Of 65,374 baseline screenings, NCNs were identified in 28,279 (43.3{\%}); lung cancer in 737 (1.1{\%}). Of 74,482 annual repeat screenings, new NCNs were identified in 4959 (7{\%}); lung cancer in 179 (0.24{\%}). Only adenocarcinoma was diagnosed in subsolid NCNs. Percentages of lung cancers by cell type were significantly different (p < 0.0001) in the baseline round compared with annual rounds, reflecting length bias, as were the ratios, reflecting lead times. Long-term K-M survival rate was 100{\%} for typical carcinoids and for adenocarcinomas manifesting as subsolid NCNs; 85{\%} (95{\%} CI 81–89{\%}) for adenocarcinoma, 74{\%} (95{\%} CI 63–85{\%}) for squamous cell, 48{\%} (95{\%} CI 34–62{\%}) for small cell. The rank ordering by lead time was the same as the rank ordering by survival rates. Conclusions: The significant differences in the frequency of NCNs and frequency and aggressiveness of diagnosed cancers in baseline and annual repeat need to be recognised for an optimal regimen of screening. Key Points: • Lung cancer aggressiveness varies considerably by cell type and nodule consistency. • Kaplan–Meier survival rates varied by cell type between 100{\%} and 48{\%}. • The percentages of lung cancers by cell type in screening rounds reflect screening biases. • Rank ordering by cell type survival is consistent with that by lead times. • Empirical evidence provides critical information for the regimen of screening.",
author = "{International Early Lung Cancer Action Program Investigators} and Henschke, {Claudia I.} and Mary Salvatore and Matthew Cham and Powell, {Charles A.} and Larry DiFabrizio and Raja Flores and Andrew Kaufman and Corey Eber and Rowena Yip and Yankelevitz, {David F.} and Henschke, {Claudia I.} and Yankelevitz, {David F.} and Rowena Yip and Dongming Xu and Raja Flores and Andrea Wolf and McCauley, {Dorothy I.} and Mildred Chen and Libby, {Daniel M.} and Smith, {James P.} and Mark Pasmantier and Reeves, {Anthony P.} and Steven Markowitz and Albert Miller and Deval, {Jose Cervera} and Heidi Roberts and Demetris Patsios and Shusuke Sone and Takaomi Hanaoka and Javier Zulueta and de-Torres, {Juan P.} and Lozano, {Maria D.} and Ralph Aye and Kristin Manning and Thomas Bauer and Stefano Canitano and Salvatore Giunta and Enser Cole and Karl Klingler and Austin, {John H.M.} and Pearson, {Gregory D.N.} and Dorith Shaham and Cheryl Aylesworth and Patrick Meyers and Shahriyour Andaz and Davood Vafai and David Naidich and Georgeann McGuinness and Barry Sheppard and Matthew Rifkin",
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International Early Lung Cancer Action Program Investigators 2018, 'Baseline and annual repeat rounds of screening: implications for optimal regimens of screening', European Radiology, vol. 28, no. 3, pp. 1085-1094. https://doi.org/10.1007/s00330-017-5029-z

Baseline and annual repeat rounds of screening : implications for optimal regimens of screening. / International Early Lung Cancer Action Program Investigators.

In: European Radiology, Vol. 28, No. 3, 01.03.2018, p. 1085-1094.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Baseline and annual repeat rounds of screening

T2 - implications for optimal regimens of screening

AU - International Early Lung Cancer Action Program Investigators

AU - Henschke, Claudia I.

AU - Salvatore, Mary

AU - Cham, Matthew

AU - Powell, Charles A.

AU - DiFabrizio, Larry

AU - Flores, Raja

AU - Kaufman, Andrew

AU - Eber, Corey

AU - Yip, Rowena

AU - Yankelevitz, David F.

AU - Henschke, Claudia I.

AU - Yankelevitz, David F.

AU - Yip, Rowena

AU - Xu, Dongming

AU - Flores, Raja

AU - Wolf, Andrea

AU - McCauley, Dorothy I.

AU - Chen, Mildred

AU - Libby, Daniel M.

AU - Smith, James P.

AU - Pasmantier, Mark

AU - Reeves, Anthony P.

AU - Markowitz, Steven

AU - Miller, Albert

AU - Deval, Jose Cervera

AU - Roberts, Heidi

AU - Patsios, Demetris

AU - Sone, Shusuke

AU - Hanaoka, Takaomi

AU - Zulueta, Javier

AU - de-Torres, Juan P.

AU - Lozano, Maria D.

AU - Aye, Ralph

AU - Manning, Kristin

AU - Bauer, Thomas

AU - Canitano, Stefano

AU - Giunta, Salvatore

AU - Cole, Enser

AU - Klingler, Karl

AU - Austin, John H.M.

AU - Pearson, Gregory D.N.

AU - Shaham, Dorith

AU - Aylesworth, Cheryl

AU - Meyers, Patrick

AU - Andaz, Shahriyour

AU - Vafai, Davood

AU - Naidich, David

AU - McGuinness, Georgeann

AU - Sheppard, Barry

AU - Rifkin, Matthew

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objectives: Differences in results of baseline and subsequent annual repeat rounds provide important information for optimising the regimen of screening. Methods: A prospective cohort study of 65,374 was reviewed to examine the frequency/percentages of the largest noncalcified nodule (NCN), lung cancer cell types and Kaplan–Meier (K-M) survival rates, separately for baseline and annual rounds. Results: Of 65,374 baseline screenings, NCNs were identified in 28,279 (43.3%); lung cancer in 737 (1.1%). Of 74,482 annual repeat screenings, new NCNs were identified in 4959 (7%); lung cancer in 179 (0.24%). Only adenocarcinoma was diagnosed in subsolid NCNs. Percentages of lung cancers by cell type were significantly different (p < 0.0001) in the baseline round compared with annual rounds, reflecting length bias, as were the ratios, reflecting lead times. Long-term K-M survival rate was 100% for typical carcinoids and for adenocarcinomas manifesting as subsolid NCNs; 85% (95% CI 81–89%) for adenocarcinoma, 74% (95% CI 63–85%) for squamous cell, 48% (95% CI 34–62%) for small cell. The rank ordering by lead time was the same as the rank ordering by survival rates. Conclusions: The significant differences in the frequency of NCNs and frequency and aggressiveness of diagnosed cancers in baseline and annual repeat need to be recognised for an optimal regimen of screening. Key Points: • Lung cancer aggressiveness varies considerably by cell type and nodule consistency. • Kaplan–Meier survival rates varied by cell type between 100% and 48%. • The percentages of lung cancers by cell type in screening rounds reflect screening biases. • Rank ordering by cell type survival is consistent with that by lead times. • Empirical evidence provides critical information for the regimen of screening.

AB - Objectives: Differences in results of baseline and subsequent annual repeat rounds provide important information for optimising the regimen of screening. Methods: A prospective cohort study of 65,374 was reviewed to examine the frequency/percentages of the largest noncalcified nodule (NCN), lung cancer cell types and Kaplan–Meier (K-M) survival rates, separately for baseline and annual rounds. Results: Of 65,374 baseline screenings, NCNs were identified in 28,279 (43.3%); lung cancer in 737 (1.1%). Of 74,482 annual repeat screenings, new NCNs were identified in 4959 (7%); lung cancer in 179 (0.24%). Only adenocarcinoma was diagnosed in subsolid NCNs. Percentages of lung cancers by cell type were significantly different (p < 0.0001) in the baseline round compared with annual rounds, reflecting length bias, as were the ratios, reflecting lead times. Long-term K-M survival rate was 100% for typical carcinoids and for adenocarcinomas manifesting as subsolid NCNs; 85% (95% CI 81–89%) for adenocarcinoma, 74% (95% CI 63–85%) for squamous cell, 48% (95% CI 34–62%) for small cell. The rank ordering by lead time was the same as the rank ordering by survival rates. Conclusions: The significant differences in the frequency of NCNs and frequency and aggressiveness of diagnosed cancers in baseline and annual repeat need to be recognised for an optimal regimen of screening. Key Points: • Lung cancer aggressiveness varies considerably by cell type and nodule consistency. • Kaplan–Meier survival rates varied by cell type between 100% and 48%. • The percentages of lung cancers by cell type in screening rounds reflect screening biases. • Rank ordering by cell type survival is consistent with that by lead times. • Empirical evidence provides critical information for the regimen of screening.

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U2 - 10.1007/s00330-017-5029-z

DO - 10.1007/s00330-017-5029-z

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SN - 0938-7994

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