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. 2017 Nov 25;17(1):155.
doi: 10.1186/s12890-017-0506-3.

Pleural plaques in lung cancer screening by low-dose computed tomography: prevalence, association with lung cancer and mortality

Mario Silva  1   2 , Nicola Sverzellati  3   4 , Davide Colombi  3 , Gianluca Milanese  3   4 , Carlo La Vecchia  5 , Carlotta Galeone  5 , Alfonso Marchianò  6 , Ugo Pastorino  4
Affiliations

Pleural plaques in lung cancer screening by low-dose computed tomography: prevalence, association with lung cancer and mortality

Mario Silva et al. BMC Pulm Med. .

Abstract

Background: To report the prevalence of pleural plaques in a lung cancer screening trial by low-dose computed tomography (LDCT) and to test the association with incidence of lung cancer and mortality.

Methods: The LDCT of 2303 screenees were retrospectively reviewed with the specific aim of describing the prevalence and features of pleural plaques. Self-administered questionnaire was used to assess asbestos exposure. Frequency of lung cancer, lung cancer mortality, and overall mortality were detailed according to presence of pleural findings. Statistical analyses included comparison of mean or median, contingency tables, and Cox model for calculation of hazard ratio (HR) and its 95% confidence interval (CI).

Results: Among male screenees, 31/1570 (2%) showed pleural abnormalities, 128/1570 (8.2%) disclosed asbestos exposure, 23/31 (74.2%) subjects with pleural plaques consistently denied exposure to asbestos. There was a trend for higher frequency of lung cancer among subjects with pleural plaques (9.7% vs 4.2%). Lung cancer in subjects with pleural plaques was always diagnosed in advanced stage. Subjects with pleural plaques showed HR 5.48 (95% CI 1.61-18.70) for mortality from lung cancer.

Conclusions: Pleural plaques are a risk factor for lung cancer mortality that can be detected in lung cancer screening by LDCT, also in subjects that are not aware of asbestos exposure.

Trial registration: NCT02837809 - Retrospectively registered July 1, 2016 - Enrolment of first participant September 2005.

Keywords: Asbestos exposure; Lung cancer screening; Pleural abnormalities; Pleural plaques; Post-test refinement of individual risk; Self-disclosure of asbestos exposure.

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Conflict of interest statement

Ethics approval and consent to participate

The Institutional Review Board of the Fondazione IRCCS Istituto Nazionale dei Tumori di Milano approved the Multicenter Italian Lung Detection (MILD) protocol, and written informed consent was obtained from all participants. Informed consent included retrospective evaluation of MILD data, as performed in this study. Therefore, specific consent was waived for this study.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests..

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a-c Pleural plaques. a-b - Transverse CT image of the chest shows smooth solid thickening of pleural surface with clear-cut edge. c – Coronal reconstruction of the chest shows smooth solid thickening of pleural surface above the diaphragm, with scant calcification
Fig. 2
Fig. 2
Geographic area of provenance of screenees are summarized according to numeric categories: 1–10 screenees, 11–100 screenees, 101–500 screenees, and > 500 screenees. The geographic distribution of pleural plaques is reported as the ratio between the number of screenees with pleural plaques and specific number of screenees from each geographic area (adapted from https://commons.m.wikimedia.org)
See this image and copyright information in PMC

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