First round of lung cancer screening among patients with atheromatous cardiovascular disease exposed to tobacco: a prospective cohort study.
Identification of populations eligible for lung cancer screening (LCS) is a priority question in this field. The primary objective of this study was to quantify lung cancer prevalence after a first round of LCS among patients with history of atheromatous cardiovascular disease (aCVD) and tobacco exposure.
We performed a prospective bi-centric descriptive quantification of lung cancer prevalence among patients aged 45-75 years old with minimal history of 10 years of daily smoking and aCVD who underwent a chest computed tomography (CT) in an intend to screen. We also described lung cancer stage at diagnosis and treatments, we evaluated the eligibility of our population to the National Lung Screening Trial (NLST) and the Dutch-Belgian randomized controlled trial (NELSON) and described main quality metrics of LCS clinical path.
Among 505 participants who underwent a chest CT 159/505 (31%) did not met NLST nor NELSON eligibility criteria, 19/505 (3.8%) participants presented a positive screening. We diagnosed 16 cancers in 15 patients resulting in a LC prevalence of 2.97% (15/505). Among 16 lung cancers, 11 were stage I or II (75%). All patients with lung cancer received specific treatments including 12 surgeries alone, 2 surgeries with adjuvant systemic therapy, 1 radiation with systemic therapy and one systemic therapy alone; there was no postoperative severe morbidity (i.e. Clavien Dindo ≥ 3).
Our exploratory descriptive prospective study suggests that age 45-75 years-old, daily smoking for 10 years and aCVD may be evaluated in future studies as additional LCS eligibility criteria to existing LCS eligibility criteria.
We performed a prospective bi-centric descriptive quantification of lung cancer prevalence among patients aged 45-75 years old with minimal history of 10 years of daily smoking and aCVD who underwent a chest computed tomography (CT) in an intend to screen. We also described lung cancer stage at diagnosis and treatments, we evaluated the eligibility of our population to the National Lung Screening Trial (NLST) and the Dutch-Belgian randomized controlled trial (NELSON) and described main quality metrics of LCS clinical path.
Among 505 participants who underwent a chest CT 159/505 (31%) did not met NLST nor NELSON eligibility criteria, 19/505 (3.8%) participants presented a positive screening. We diagnosed 16 cancers in 15 patients resulting in a LC prevalence of 2.97% (15/505). Among 16 lung cancers, 11 were stage I or II (75%). All patients with lung cancer received specific treatments including 12 surgeries alone, 2 surgeries with adjuvant systemic therapy, 1 radiation with systemic therapy and one systemic therapy alone; there was no postoperative severe morbidity (i.e. Clavien Dindo ≥ 3).
Our exploratory descriptive prospective study suggests that age 45-75 years-old, daily smoking for 10 years and aCVD may be evaluated in future studies as additional LCS eligibility criteria to existing LCS eligibility criteria.
Authors
Armand Armand, Buton Buton, Caramella Caramella, Habert Habert, Hamouda Hamouda, Hamidou Hamidou, Issard Issard, Pradère Pradère, Dauriat Dauriat, Mussot Mussot, Mitilian Mitilian, Hache Hache, Lamrani Lamrani, Pavec Pavec, Zins Zins, Fidelle Fidelle, Pluvy Pluvy, Brioude Brioude, Todesco Todesco, Lovato Lovato, Tronchetti Tronchetti, Dutau Dutau, Greillier Greillier, Gaubert Gaubert, Jacquier Jacquier, Trousse Trousse, D'journo D'journo, Thomas Thomas, Fadel Fadel, Haulon Haulon, Fabre Fabre, Ghostine Ghostine, Kloeckner Kloeckner, Abdayem Abdayem, Kroemer Kroemer, Zitvogel Zitvogel, Besse Besse, Mercier Mercier, Boulate Boulate
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