Virtual Library
Start Your Search
Yeon Wook Kim
Author of
-
+
MA05 - Lung Cancer Screening (ID 174)
- Event: WCLC 2020
- Type: Mini Oral
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 1/30/2021, 11:45 - 12:45, Scientific Program Auditorium
-
+
MA05.05 - Low-Dose Chest Computed Tomographic Screening and Invasive Diagnosis of Pulmonary Nodules for Lung Cancer in Never-Smokers (ID 692)
11:45 - 12:45 | Presenting Author(s): Yeon Wook Kim
- Abstract
- Presentation
Introduction
Although lung cancer screening using low-dose computed tomography (LDCT) is now widely used in clinical practice, the characteristics and outcomes of diagnostic procedures related to screen-detected nodules in never-smokers remain unclear. We aimed to determine the incidence of nodules considered for invasive biopsy and evaluate the final diagnoses and procedure-related complications in never-smokers in comparison to ever-smokers who underwent LDCT screening.
Methods
We evaluated 37,436 asymptomatic adults (17,968 never-smokers and 19,468 ever-smokers) who underwent LDCT screening for lung cancer between January 2009 and December 2018 at a tertiary centre in South Korea. The rates of invasive diagnostic procedures for detected nodules and related complications, and the diagnostic outcomes were determined in the never-smoker and ever-smoker groups.
Results
Among the never-smokers, 2,908/17,968 (16.2%) had positive nodules. Overall, 139/17,968 (0.77%) never-smokers and 194/19,468 (1.00%) ever-smokers underwent invasive biopsy (p=0.022). Lung cancer was diagnosed in 84/17,968 (0.47%) of never-smokers and 123/19,468 (0.63%) of ever-smokers (p=0.032). The proportions of participants diagnosed with benign disease after invasive biopsy (false-positive) were 50/17,968 (0.28%) and 69/19,468 (0.35%) in the never-smoker and ever-smoker groups (p=0.191). Multivariate analyses revealed no significant associations of smoking with the risk of a false-positive diagnosis (OR=0.98, 95% CI=0.62–1.57) and complications (OR=1.33, 95% CI=0.65–3.73) after biopsy. Of the 84 never-smokers with lung cancer, 82/84 (97.6%) had adenocarcinoma, and 75/84 (89.3%) were in stage I with a favourable prognosis.
Conclusion
LDCT screening in never-smokers resulted in a notable detection rate of lung nodules, which warranted invasive biopsy. The lung cancer detection rate was lower in never-smokers than in ever-smokers. However, no significant differences in the false-positive and complication rates were observed between the two groups. Accordingly, a more specifically tailored management strategy is needed for screen-detected nodules in Asian never-smokers.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
P45 - Screening and Early Detection - Radiological Risk Stratification (ID 182)
- Event: WCLC 2020
- Type: Posters
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
-
+
P45.01 - Lung Cancer Probability and Clinical Outcomes of Baseline and New Ground-Glass Opacity Nodules Detected on Low-Dose CT Screening (ID 754)
00:00 - 00:00 | Presenting Author(s): Yeon Wook Kim
- Abstract
Introduction
Limited data are available on ground-glass opacity nodules (GGNs) detected on lung cancer screening with low-dose computed tomography (LDCT). We aimed to determine the characteristics of screen-detected GGNs, and evaluate the probability of lung cancer and the clinical course of GGNs detected at baseline and during follow-up screening.
Methods
We evaluated 50,132 (22,631 never-smokers and 27,501 ever-smokers) adults who underwent LDCT screening for lung cancer between May 2003 and June 2019 at a tertiary center in South Korea. The incidence, characteristics, and clinical outcomes of the baseline and new screen-detected GGNs were determined.
Results
A total of 6,725 GGNs were detected in 4,545 participants (1,484 new GGNs detected in 937 [1.9%] participants; overall incidence of GGNs: 10.7% in never-smokers and 7.7% in ever-smokers; p<0.001). The baseline GGNs had a lower rate of resolution (30.0% vs 78.9%, p<0.001), but a higher rate of lung cancer diagnosis (4.0% vs 1.1%, p<0.001) than the new GGNs. Among 293 biopsied GGNs, 227 (77.5%) were diagnosed as lung cancer, of which 226 (99.6%) were adenocarcinomas. No significant difference was observed in pathological invasiveness or initial stage between the baseline and new cancerous GGNs. Multivariate regression analyses revealed that detection at baseline screening was significantly associated with a higher probability of lung cancer (OR=4.59, 95% CI=2.70–7.82) and overall growth (OR=2.51, 95% CI=1.73–3.66), but a lower probability of resolution (OR=0.11, 95% CI=0.09–0.12).
Conclusion
LDCT screening led to a considerably high rate of GGN detection, particularly in never-smokers. Compared to the baseline GGNs, the new GGNs were associated with a lower probability of lung cancer and higher probability of spontaneous resolution, indicating their more inflammatory nature. We recommend that less aggressive follow-up may be allowed for new GGNs in the guidelines drafted in the future.
