Claudia I Henschke1, Mary Salvatore2, Matthew Cham2, Charles A Powell3, Larry DiFabrizio3, Raja Flores4, Andrew Kaufman4, Corey Eber2, Rowena Yip2, David F Yankelevitz2. 1. Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA. Claudia.Henschke@mountsinai.org. 2. Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA. 3. Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 4. Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Abstract
OBJECTIVES: Differences in results of baseline and subsequent annual repeat rounds provide important information for optimising the regimen of screening. METHODS: A prospective cohort study of 65,374 was reviewed to examine the frequency/percentages of the largest noncalcified nodule (NCN), lung cancer cell types and Kaplan-Meier (K-M) survival rates, separately for baseline and annual rounds. RESULTS: Of 65,374 baseline screenings, NCNs were identified in 28,279 (43.3%); lung cancer in 737 (1.1%). Of 74,482 annual repeat screenings, new NCNs were identified in 4959 (7%); lung cancer in 179 (0.24%). Only adenocarcinoma was diagnosed in subsolid NCNs. Percentages of lung cancers by cell type were significantly different (p < 0.0001) in the baseline round compared with annual rounds, reflecting length bias, as were the ratios, reflecting lead times. Long-term K-M survival rate was 100% for typical carcinoids and for adenocarcinomas manifesting as subsolid NCNs; 85% (95% CI 81-89%) for adenocarcinoma, 74% (95% CI 63-85%) for squamous cell, 48% (95% CI 34-62%) for small cell. The rank ordering by lead time was the same as the rank ordering by survival rates. CONCLUSIONS: The significant differences in the frequency of NCNs and frequency and aggressiveness of diagnosed cancers in baseline and annual repeat need to be recognised for an optimal regimen of screening. KEY POINTS: • Lung cancer aggressiveness varies considerably by cell type and nodule consistency. • Kaplan-Meier survival rates varied by cell type between 100% and 48%. • The percentages of lung cancers by cell type in screening rounds reflect screening biases. • Rank ordering by cell type survival is consistent with that by lead times. • Empirical evidence provides critical information for the regimen of screening.
OBJECTIVES: Differences in results of baseline and subsequent annual repeat rounds provide important information for optimising the regimen of screening. METHODS: A prospective cohort study of 65,374 was reviewed to examine the frequency/percentages of the largest noncalcified nodule (NCN), lung cancer cell types and Kaplan-Meier (K-M) survival rates, separately for baseline and annual rounds. RESULTS: Of 65,374 baseline screenings, NCNs were identified in 28,279 (43.3%); lung cancer in 737 (1.1%). Of 74,482 annual repeat screenings, new NCNs were identified in 4959 (7%); lung cancer in 179 (0.24%). Only adenocarcinoma was diagnosed in subsolid NCNs. Percentages of lung cancers by cell type were significantly different (p < 0.0001) in the baseline round compared with annual rounds, reflecting length bias, as were the ratios, reflecting lead times. Long-term K-M survival rate was 100% for typical carcinoids and for adenocarcinomas manifesting as subsolid NCNs; 85% (95% CI 81-89%) for adenocarcinoma, 74% (95% CI 63-85%) for squamous cell, 48% (95% CI 34-62%) for small cell. The rank ordering by lead time was the same as the rank ordering by survival rates. CONCLUSIONS: The significant differences in the frequency of NCNs and frequency and aggressiveness of diagnosed cancers in baseline and annual repeat need to be recognised for an optimal regimen of screening. KEY POINTS: • Lung cancer aggressiveness varies considerably by cell type and nodule consistency. • Kaplan-Meier survival rates varied by cell type between 100% and 48%. • The percentages of lung cancers by cell type in screening rounds reflect screening biases. • Rank ordering by cell type survival is consistent with that by lead times. • Empirical evidence provides critical information for the regimen of screening.
Authors: Claudia I Henschke; David F Yankelevitz; Rowena Yip; Anthony P Reeves; Ali Farooqi; Dongming Xu; James P Smith; Daniel M Libby; Mark W Pasmantier; Olli S Miettinen Journal: Radiology Date: 2012-03-27 Impact factor: 11.105
Authors: C I Henschke; D I McCauley; D F Yankelevitz; D P Naidich; G McGuinness; O S Miettinen; D M Libby; M W Pasmantier; J Koizumi; N K Altorki; J P Smith Journal: Lancet Date: 1999-07-10 Impact factor: 79.321
Authors: Nanda Horeweg; Carlijn M van der Aalst; Erik Thunnissen; Kristiaan Nackaerts; Carla Weenink; Harry J M Groen; Jan-Willem J Lammers; Joachim G Aerts; Ernst T Scholten; Joost van Rosmalen; Willem Mali; Matthijs Oudkerk; Harry J de Koning Journal: Am J Respir Crit Care Med Date: 2013-04-15 Impact factor: 21.405
Authors: J K Field; S W Duffy; D R Baldwin; D K Whynes; A Devaraj; K E Brain; T Eisen; J Gosney; B A Green; J A Holemans; T Kavanagh; K M Kerr; M Ledson; K J Lifford; F E McRonald; A Nair; R D Page; M K B Parmar; D M Rassl; R C Rintoul; N J Screaton; N J Wald; D Weller; P R Williamson; G Yadegarfar; D M Hansell Journal: Thorax Date: 2015-12-08 Impact factor: 9.139
Authors: Giulia Veronesi; David R Baldwin; Claudia I Henschke; Simone Ghislandi; Sergio Iavicoli; Matthijs Oudkerk; Harry J De Koning; Joseph Shemesh; John K Field; Javier J Zulueta; Denis Horgan; Lucia Fiestas Navarrete; Maurizio Valentino Infante; Pierluigi Novellis; Rachael L Murray; Nir Peled; Cristiano Rampinelli; Gaetano Rocco; Witold Rzyman; Giorgio Vittorio Scagliotti; Martin C Tammemagi; Luca Bertolaccini; Natthaya Triphuridet; Rowena Yip; Alexia Rossi; Suresh Senan; Giuseppe Ferrante; Kate Brain; Carlijn van der Aalst; Lorenzo Bonomo; Dario Consonni; Jan P Van Meerbeeck; Patrick Maisonneuve; Silvia Novello; Anand Devaraj; Zaigham Saghir; Giuseppe Pelosi Journal: Cancers (Basel) Date: 2020-06-24 Impact factor: 6.639
Authors: Claudia I Henschke; David F Yankelevitz; Artit Jirapatnakul; Rowena Yip; Vivian Reccoppa; Charlene Benjamin; Tserling Llamo; Angel Williams; Simon Liu; Daniel Max; Samuel M Aguayo; Providencia Morales; Brian J Igel; Hamed Abbaszadegan; Peter A Fredricks; Daniel P Garcia; Paska A Permana; Janet Fawcett; Samir Sultan; Lorenza A Murphy Journal: Transl Lung Cancer Res Date: 2021-02
Authors: Claudia I Henschke; Rowena Yip; Dorith Shaham; Javier J Zulueta; Samuel M Aguayo; Anthony P Reeves; Artit Jirapatnakul; Ricardo Avila; Drew Moghanaki; David F Yankelevitz Journal: J Thorac Imaging Date: 2021-01 Impact factor: 5.528