Author of

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  P2.11 - Screening and Early Detection (Not CME Accredited Session) (ID 960)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 27138

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    P2.11-16 - Comparison of Two Lung Cancer Screening Programs in One Medical Center - Does Experience of the Screening Team and Indications Affect the Results? (ID 12965)

    16:45 - 18:00  |  Author(s): Malgorzata Jelitto-Gorska
    • Abstract
    • Slides

    Background
    

    Onset of lung cancer (LC) screening programs in Europe is expected in near future in form of stepwise process. Yet, several issues need improvement. We compared two screening programs performed in Gdańsk, Poland by one multidisciplinary team in over 14,000 individuals – Pomeranian Pilot Lung Cancer Screening Program (PPP) and Moltest Bis (MB). We assessed how do the indications and learning curve affect results.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Between 2009-2011, 8,649 healthy volunteers (aged 50-75, >20 pack-years) were recruited to PPP. Between 2016-2017, 5,534 healthy volunteers (aged 50-79, >30 pack-years) entered MB. Early MB results are presented as it will be closed in May 2018. Positive computed tomography’s (LDCT) result in the first round led to secondary screening. Three rounds of LDCT screening in PPP and two rounds in MB were performed in suspected lung nodules. All positive results were assessed by this same multidisciplinary team.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Detection rates of lung nodules requiring follow-up were 34.7% of PPP and 17.6% of MB subjects (p<0.0001). LC was diagnosed in 107 (1.24%) PPP and 105 (1.90%) MB participants (p=0.0016). Three hundred (3.5%) PPP and 199 (3.6%) MB patients were referred for further diagnostic work-up (p=0.6890). Yet, more MB patients were sent for diagnostic work-up after first screening round - 85.9% vs 75.7% in PPP (p=0.0050). Fine needle aspiration biopsy was more often positive among LC subjects in MB (84.7% vs 54.0% in PPP; p=0.0002). Surgical resection was performed in 125 (1.5%) PPP and 80 (1.5%) MB patients (p=0.7385), with 19.2% and 15.0% of futile interventions, respectively. Lobectomies or segmentectomies were performed in 84.0% and 90.0% of LC patients in PPP and MB, respectively (p=0.2160). MB patients more often underwent video-assisted thoracoscopic resections – 73.0% vs 24.0% in PPP (p<0.0001). Complication rates were comparable in both programs – 11.2% in PPP vs 17.1% in MB (p=0.0560). Majority of subjects with non-small cell lung cancer (NSCLC) had stage I or II – 86.4% in PPP and 83.4% in MB (p=0.442). Rate of stage I NSCLC within surgical group was higher in MB (86.0% vs 79.0% in PPP; p<0.001).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Narrower inclusion criteria (>30 pack-years) and increased upper age limit (79 years) led to higher detection rate and number of operated early stage NSCLC patients. Experience gained in PPP has resulted in reduction of number of nodules requiring follow-up but not reduction of “unnecessary” diagnostic work up and surgical treatment. Minimally invasive surgery was applied significantly more often with broader experience.

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