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M. Patricia Rivera
Author of
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GS01 - Opening & Keynote Lectures (ID 7)
- Event: NACLC 2019
- Type: Invited Speaker Session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 10/10/2019, 18:00 - 19:30, Rouge (Lobby Level)
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GS01.05 - Disparities in Screening (ID 145)
18:00 - 19:30 | Presenting Author(s): M. Patricia Rivera
- Abstract
Abstract not provided
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OA02 - Screening and IO Toxicity (ID 2)
- Event: NACLC 2019
- Type: Oral Abstract Session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 10/12/2019, 09:45 - 11:15, Imperial Ballroom (B2 Level)
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OA02.06 - Lung Cancer Screening in Patients With Versus Without a Personal History of Cancer (ID 72)
09:45 - 11:15 | Presenting Author(s): M. Patricia Rivera
- Abstract
Background:
Cancer survivors have an 8.1% chance for developing a second primary malignancy (SPM), with lung cancer being the most commonly diagnosed SPM. Only 4% of participants enrolled in the National Lung Screening Trial (NLST) had a personal history of cancer (PHC). Expanding lung cancer screening (LCS) to individuals with a PHC raises concerns for increased harms due to the possibility of more positive findings requiring follow-up and a higher prevalence of comorbidities.
Method:
The cohort included 1,393 patients who underwent 2,001 LCS exams from January 2015 to March 2019 at three healthcare facilities in North Carolina. From radiology reports we abstracted screening interpretation as measured by the American College of Radiology’s (ACR) Lung Reporting and Data System (Lung-RADS) and we dichotomized into negative (Lung-RADS 1 or 2) or positive (Lung-RADS 3, 4A, 4B, 4X). Patient characteristics were compared using chi-square tests. Likelihood of a positive LCS exam was assessed using multivariate logistic regression adjusting for age, sex, race, smoking status, and family history of lung cancer.
Results:
There were 358(17.9%) exams in patients with a PHC and 1,643 (82.1%) in those with no PHC. Patients with a PHC (n=245) were more often older (p=0.0467), female (p=0.0032), and white (p=0.0120). There were no differences among those with and without a PHC with respect to smoking status or presence of comorbidities. In adjusted models, the likelihood of a positive LCS result in patients with versus without a PHC were similar on baseline (adjusted odds ratio (aOR)=1.22, 95% CI: 0.85-1.77) and subsequent exams (aOR=1.19, 95% CI: 0.66-2.15) (Table 1)
Conclusion:
While patients with a PHC were more likely to be older, we did not find a higher rate of comorbidities nor of positive LCS exams when compared to patients without a PHC. Further studies are needed to evaluate the benefit and harms of LCS in smokers with a PHC.
