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Damian Czyzewski
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EP1.11 - Screening and Early Detection (ID 201)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.11-17 - The Impact of Occupational Exposure on Detection of Extra-Nodular and Extrapulmonary Lesions in LDCT from a Pilot Silesian Study (Now Available) (ID 2606)
08:00 - 18:00 | Author(s): Damian Czyzewski
- Abstract
Background
Smoking and additional exposure to occupational factors such as coal dust, can cause changes in the lungs and also in other organs.
Method
We did the comparative analysis of the prevalence and nature of extra-nodular lesions and extra-pulmonary findings seen in low-dose computed tomographies (LDCT) done in 533 participants of the Pilot Silesian Study of Early Lung Cancer Detection. The study cohort consisted of miners (n=59) and people without occupational exposure (n=474). Statistical analysis was performed using Statistica 13.0 PL. Statistical significance was set at a p value below 0.05. Distribution of variables was evaluated by the Shapiro-Wilk test. The two groups were compared with the U Mann-Whitney test in case of non-normal data distribution. Chi-square test was used.
Result
The value of ‘pack-years’ for miners was statistically higher than for people without occupational exposure (M: 37 v 30, p=0.01 ). Emphysema was more often found in the group of miners ( 44,07 % v 31,50 %, p = 0.05). COPD was also diagnosed more often in people exposed to coal dust than without occupational risk (45,76 % v 32,07 %, p=0.035). Extrapulmonary findings were reported in 86,44 % of miners and 62,45 % of people without occupational exposure (p=0.00027). Degenerative changes in the skeleton, osteoporosis, calcification in vessels were found statistically more frequently in miners.
Conclusion
Long-term smoking, exposure to coal dust, physical work could contribute to a faster development of COPD and osteoarticular diseases.
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P1.11 - Screening and Early Detection (ID 177)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.11-01 - The Implementation of the Lung-RADS ™ in Pilot Silesian Study with LDCT - An Opportunity for Better Control of Overdiagnosis (ID 2629)
09:45 - 18:00 | Author(s): Damian Czyzewski
- Abstract
Background
A high percentage of false positive results observed in lung cancer screening (LCS) studies with LDCT was the reason for the modification of radiological assesement methods. Originally, all non-calcified nodules with a dimension ≥ 4 mm were considered as positive, whereas the implementation of the Lung-RADS ™ recommends additional testing only for nodules ≥ 6 mm in categories 3 and 4. This allowed for the reduction of false positive results and avoiding the effect of "overdiagnosis" (unnecessary interventions).
Method
We retrospectively analyzed 601 of first round LDCT scans, performed in 2010-2012 in asymptomatic volunteers of Pilot Silesian Study of Early Lung Cancer Detection with Low-Dose CT, with a smoking history of at least 20 pack-years, who actively smoked tobacco or quit smoking in the last 15 years. The analysis of non-invasive (additional examinations with contrast CT) and invasive interventions (bronchoscopy, EBUS, biopsies, surgery) done in screening participants was performed, followed by assessment of nodules according to the Lung-RADS ™ system, grouping them to 2, 3, 4A and 4B categories. Then the percentage of interventions that could be avoided using the ACR LungRADS ™ criteria was estimated.
Result
In total, 1016 nodules of solid, partial-solid and non-solid morphology were identified in 265 participants. In the entire screening cohort 87 interventions were performed, including 58 (66.6%) non-invasive and 29 (33.3%) invasive. Among nodules belonging to category 4A and B, 8 invasive lung cancers were identified, 1lung cancer was overlooked (false negative) and in 1 case metastases from colorectal cancer were diagnosed. With the using of LungRADS ™ criteria, 34.4% of non-invasive and 8% of invasive interventions in categories 2 and 3 could be avoided.
Conclusion
The LungRADS ACR classification system proved to be a practical tool for assessing lung nodules, which allowed to significantly reduce the effect of "overdiagnosis" especially in category 2 where the probability of lung cancer is low (<1%).
