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MA01 - Improvement and Implementation of Lung Cancer Screening (ID 368)
- Event: WCLC 2016
- Type: Mini Oral Session
- Track: Radiology/Staging/Screening
- Presentations: 1
MA01.11 - Implementation of LDCT Lung Cancer Screening into Practice. Results of Regional Early Detection Program (ID 5568)
11:00 - 12:30 | Author(s): C. Piwkowski
Lung cancer is the leading cause of cancer deaths both in men and women in either Wielkopolska and the whole Poland. Wielkopolska is one of Polish regions (voivodships) with about 3,4 mln inhabitants and incidence of lung cancer aprox. 1900 new cases every year. Screening by low dose computer tomography (LDCT) showed reduction of lung cancer mortality in NLST trial. Regional authorities covered this program from local budget beside Polish health system.
Since october 2009 program of early detection of lung cancer started in 5 centers of Wielkopolska region. Till the end of 2015 N=17222 subjects were screened. The entry criteria were: age between 55 and 70 years and smoking ≥ 20 packyears. Every person has the LDCT performed. Results were first clasified as normal or abnormal. Abnormalities were divided into 6 categories: <5mm single, <5 mm multiple, 5-15 mm single, 5-15 mm multiple, >15 mm single, >15 mm multiple. Patient received also recomendation for further actions. Results presented are based on annual reports for regional authorities.
More than 85% of the images were clasified as abnormal. Nodes of any kind were found in about 47% of entire population. More than 3000 patient received recomendation for further diagnostic evaluation. Finally 108 patients underwent surgery (37 lobectomies, 41 wedge resections, 30 thoracotomies/thoracoscopies). There were 92 cases of lung cancer confirmed (11 SCLC, 78 NSCLC, 3 carcinoids) and 1 case of mesothelioma.
Lung cancer screening program identifies magnitude of lung changes. Many patients requires further diagnostic procedures. Most of them are fibrotic, post inflammatory changes. It is possible to diagnose lung cancer in early presymptomatic stage but numbers are low and risk models or biomarkers should be implemented to better define patients / nodules at risk.
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