Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb;157(2):427-434.
doi: 10.1016/j.chest.2019.08.2187. Epub 2019 Sep 12.

Use of Imaging and Diagnostic Procedures After Low-Dose CT Screening for Lung Cancer

Shawn P E Nishi  1 , Jie Zhou  2 , Ikenna Okereke  3 , Yong-Fang Kuo  4 , James Goodwin  5
Affiliations

Use of Imaging and Diagnostic Procedures After Low-Dose CT Screening for Lung Cancer

Shawn P E Nishi et al. Chest. 2020 Feb.

Abstract

Background: Clinical trials have demonstrated a mortality benefit from lung cancer screening by low-dose CT (LDCT) in current or past tobacco smokers who meet criteria. Potential harms of screening mostly relate to downstream evaluation of abnormal screens. Few data exist on the rates outside of clinical trials of imaging and diagnostic procedures following screening LDCT. We describe rates in the community setting of follow-up imaging and diagnostic procedures after screening LDCT.

Methods: We used Clinformatics Data Mart national database to identify enrollees age 55 to 80 year who underwent screening LDCT from January 1, 2016, to December 31, 2016. We assessed rates of follow-up imaging (diagnostic chest CT scan, MRI, and PET) and follow-up procedures (bronchoscopy, percutaneous biopsy, thoracotomy, mediastinoscopy, and thoracoscopy) in the 12 months following LDCT for lung cancer screening. We also assessed these rates in an age-, sex-, and number of comorbidities-matched population that did not undergo LDCT to estimate rates unrelated to the screening LDCT. We then reported the adjusted rate of follow-up testing as the observed rate in the screening LDCT population minus the rate in the non-LDCT population.

Results: Among 11,520 enrollees aged 55 to 80 years who underwent LDCT in 2016, the adjusted rates of follow up 12 months after LDCT examinations were low (17.7% for imaging and 3.1% for procedures). Among procedures, the adjusted rates were 2.0% for bronchoscopy, 1.3% for percutaneous biopsy, 0.9% for thoracoscopy, 0.2% for mediastinoscopy, and 0.4% for thoracotomy. Adjusted rates of follow-up procedures were higher in enrollees undergoing an initial screening LDCT (3.3%) than in those after a second screening examination (2.2%).

Conclusions: In general, imaging and rates of procedures after screening LDCT was low in this commercially insured population.

Keywords: LDCT; NLST; chest imaging; computed tomography; follow up; health-care utilization; imaging; lung cancer screening; procedures.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cumulative percentage of chest CT, MRI, and PET scans in the 12 months after LDCT. LDCT = low-dose CT.
Figure 2
Figure 2
Cumulative percentage of bronchoscopy, thoracotomy, thoracoscopy, mediastinoscopy, or percutaneous biopsy in 12 months after LDCT scan. See Figure 1 legend for expansion of abbreviation.
See this image and copyright information in PMC

Comment in

References

    1. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30. - PubMed
    1. National Lung Screening Trial Research Team. Aberle D.R., Adams A.M. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395–409. - PMC - PubMed
    1. Moyer V.A., US Preventive Services Task Force Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330–338. - PubMed
    1. NELSON study shows CT screening for nodule volume management reduces lung cancer mortality by 26 percent in men [press release]. IASLC 19th World Conference on Lung Cancer (WCLC). September 25, 2018.
    1. National Lung Screening Trial Research Team. Aberle D.R., Adams A.M. Baseline characteristics of participants in the randomized national lung screening trial. J Natl Cancer Inst. 2010;102(23):1771–1779. - PMC - PubMed

Publication types

MeSH terms