Author of

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  P41 - Screening and Early Detection - Lung Cancer Screening Programmes (ID 176)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Screening and Early Detection
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35609

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    P41.04 - The SUMMIT Study: Pulmonary Nodule and Incidental Findings in the First 10,000 Participants of a Population-Based Low-Dose CT Screening Study (ID 2169)

    00:00 - 00:00  |  Presenting Author(s): Jennifer L Dickson
    • Abstract
    • Slides

    Introduction
    

    A robust evidence base to support the management of pulmonary nodules (PNs) and incidental findings (IFs) is crucial in establishing wider roll-out of low-dose CT (LDCT) lung cancer screening in the UK, to optimise resource utilisation and minimise preventable harms. We report the prevalence of PNs and IFs from the first 10,000 participants in the SUMMIT Study lung cancer screening (LCS) cohort and examine the impact of a pre-defined management protocol on repeat imaging, as well as primary and secondary care referrals.

    Methods
    

    The SUMMIT Study, a population-based LCS study which opened in April 2019 in north and east London, aims to assess the implementation of LDCT for lung cancer screening in a high-risk population and to validate a multi-cancer early detection blood test. A priori, evidence-based protocols were developed to inform the management of pulmonary nodules, and intra- and extrapulmonary IFs. Our proforma-based reporting system presents algorithm-derived management recommendations for the reporting radiologist to approve or override. PNs and IFs are categorised according to the consequent clinical management plan (Table 1).

    

    Results
    

    We report outcomes from the first 10,000 SUMMIT Study participants with completed baseline LDCT reports. Median age was 65 years (IQR 60-70), 57.7% were male, and 48.1% were current smokers.

    3110 actionable PNs were identified in 1984 participants. 323 participants (3.2% of total) had 388 nodules that required immediate referral to a multidisciplinary team (MDT). 1479 (47.5%) and 433 (13.9%) nodules were indeterminate SNs and PSNs respectively, requiring 3 month follow up imaging. 810 (26.0%) of the 3110 PNs were GGNs, necessitating a repeat scan at a year. 16581 radiological IFs were detected in 8262 participants. Of these, 14608 findings (88%) were documented for research purposes only and 1195 (7%) will be followed up within the study. 496 (5%) participants had 505 IFs requiring action by their primary care team. 265 participants (2.7%) required an urgent referral due to IF(s).

    Conclusion
    

    Implementation of defined PN and IF protocols has enabled streamlined management of radiological findings, resulting in low urgent referral rates when compared to previously reported studies. Direct comparison remains difficult due to the variability in reporting and managing PNs and particularly IFs in other LCS studies and services. Forthcoming outcome data from the SUMMIT Study will further inform whether this strategy can be recommended more widely.

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