Lung Cancer Diagnosed Through Screening, Lung Nodule, and Neither Program: A Prospective Observational Study of the Detecting Early Lung Cancer (DELUGE) in the Mississippi Delta Cohort. Issue 19 (1st July 2022)

• Record Type: Journal Article
• Authors: Osarogiagbon, Raymond U.; Liao, Wei; Faris, Nicholas R.; Meadows-Taylor, Meghan; Fehnel, Carrie; Lane, Jordan; Williams, Sara C.; Patel, Anita A.; Akinbobola, Olawale A.; Pacheco, Alicia; Epperson, Amanda; Luttrell, Joy; McCoy, Denise; McHugh, Laura; Signore, Raymond; Bishop, Anna M.; Tonkin, Keith; Optican, Robert; Wright, Jeffrey; Robbins, Todd; Ray, Meredith A.; Smeltzer, Matthew P.
• Is Part Of: Journal of clinical oncology. Volume 40:Issue 19(2022)
• Page Start: 2094
• Page End: 2105
• Publication Date: 2022-07-01
• Subjects: Oncology -- Periodicals; Cancer -- Periodicals; Oncology; Medical Oncology; Cancérologie -- Périodiques; Cancer -- Périodiques; Cancérologie; Cancer; Oncology; Oncologia; Càncer; Periodicals; 616.994
• DOI: 10.1200/JCO.21.02496
• Languages: English
• ISSNs: 0732-183X

Abstract

Abstract : PURPOSE: Lung cancer screening saves lives, but implementation is challenging. We evaluated two approaches to early lung cancer detection—low-dose computed tomography screening (LDCT) and program-based management of incidentally detected lung nodules. METHODS: A prospective observational study enrolled patients in the early detection programs. For context, we compared them with patients managed in a Multidisciplinary Care Program. We compared clinical stage distribution, surgical resection rates, 3- and 5-year survival rates, and eligibility for LDCT screening of patients diagnosed with lung cancer. RESULTS: From 2015 to May 2021, 22, 886 patients were enrolled: 5, 659 in LDCT, 15, 461 in Lung Nodule, and 1, 766 in Multidisciplinary Care. Of 150, 698, and 1, 010 patients diagnosed with lung cancer in the respective programs, 61%, 60%, and 44% were diagnosed at clinical stage I or II, whereas 19%, 20%, and 29% were stage IV ( P = .0005); 47%, 42%, and 32% had curative-intent surgery ( P < .0001); aggregate 3-year overall survival rates were 80% (95% CI, 73 to 88) versus 64% (60 to 68) versus 49% (46 to 53); 5-year overall survival rates were 76% (67 to 87) versus 60% (56 to 65) versus 44% (40 to 48), respectively. Only 46% of 1, 858 patients with lung cancer would have been deemed eligible for LDCT by US Preventive Services Task Force (USPSTF) 2013 criteria, and 54% by 2021 criteria. Even if all eligible patients by USPSTF 2021 criteria had been enrolled into LDCT, the Nodule Program would have detected 20% of the stage I-II lung cancer in the entire cohort. CONCLUSION: LDCT and Lung Nodule Programs are complementary, expanding access to early lung cancer detection and curative treatment to different-risk populations. Implementing Lung Nodule Programs may alleviate emerging disparities in access to early lung cancer detection. Abstract : Lung Nodule Program complements LDCT lung cancer screening, expands access, and reduces disparities.