Risk stratification based on screening history: the NELSON lung cancer screening study.
Thorax
; 72(9): 819-824, 2017 09.
Article
em En
| MEDLINE
| ID: mdl-28360223
ABSTRACT
BACKGROUND:
Debate about the optimal lung cancer screening strategy is ongoing. In this study, previous screening history of the Dutch-Belgian Lung Cancer Screening trial (NELSON) is investigated on if it predicts the screening outcome (test result and lung cancer risk) of the final screening round.METHODS:
15â 792 participants were randomised (11) of which 7900 randomised into a screening group. CT screening took place at baseline, and after 1, 2 and 2.5â years. Initially, three screening outcomes were possible negative, indeterminate or positive scan result. Probability for screening outcome in the fourth round was calculated for subgroups of participants.RESULTS:
Based on results of the first three rounds, three subgroups were identified (1) those with exclusively negative results (n=3856; 73.0%); (2) those with ≥1 indeterminate result, but never a positive result (n=1342; 25.5%); and (3) with ≥1 positive result (n=81; 1.5%). Group 1 had the highest probability for having a negative scan result in round 4 (97.2% vs 94.8% and 90.1%, respectively, p<0.001), and the lowest risk for detecting lung cancer in round 4 (0.6% vs 1.6%, p=0.001). 'Smoked pack-years' and 'screening history' significantly predicted the fourth round test result. The third round results implied that the risk for detecting lung cancer (after an interval of 2.5â years) was 0.6% for those with negative results compared with 3.7% of those with indeterminate results.CONCLUSIONS:
Previous CT lung cancer screening results provides an opportunity for further risk stratifications of those who undergo lung cancer screening. TRIAL REGISTRATION NUMBER Results, ISRCTN63545820.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Detecção Precoce de Câncer
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Neoplasias Pulmonares
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article