Reenika Aggarwal1, Andrew C L Lam2, Maureen McGregor3, Ravi Menezes4, Katrina Hueniken3, Hannah Tateishi2, Grainne M O'Kane3, Ming Sound Tsao5, Frances A Shepherd3, Wei Xu6, Micheal McInnis7, Heidi Schmidt7, Geoffrey Liu8, John Kavanagh7. 1. Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 2. Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 3. Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. 4. Toronto Joint Department of Medical Imaging Research, University of Toronto, Toronto, Ontario, Canada. 5. Department of Laboratory Medicine and Pathobiology, University Health Network, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada. 6. Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Princess Margaret Cancer Centre and Biostatistics, University Health Network, Toronto, Ontario, Canada. 7. Department of Cardiothoracic Imaging, Toronto Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. 8. Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada. Electronic address: geoffrey.liu@uhn.ca.
Abstract
INTRODUCTION: We hypothesize that the incidence of screen-detected lung cancer (LC), in participants with previously negative scans, will be highest in the cohort with the highest baseline risk score. METHODS: Individuals with negative baseline screening results from the Princess Margaret International Early Lung Cancer Action Program before 2009 underwent low-dose computed tomography rescreening from 2015 to 2018. Individuals were contacted in order of descending risk, as determined by the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial's PLCOM2012 6-year LC risk-prediction model, and then categorized into three risk cohorts according to their baseline risks. The incidence of LC in each risk cohort was determined and compared. Chi-square testing was used for categorical variables and one-way analysis of variance on ranks was used for continuous variables. RESULTS: Of the 1261 participants we attempted to re-contact, 359 participants returned for a rescreening scan (mean of 7.6 years between scans). Participants were divided into low (<2%), moderate (≥2% to <3.5%), and high baseline risk (≥3.5%) cohorts. On average, those in the high-risk cohort compared to the moderate- and low-risk cohorts were older (66 years versus 62 and 59 years) and had a greater smoking history (54 pack-years versus 47 and 29 pack-years). The incidence of cancer in the high-risk cohort was significantly higher than in the moderate-risk cohort (11% versus 1.7%, p = 0.002). CONCLUSIONS: There was a significantly higher incidence of LC in the high-risk cohort than in the moderate-risk cohort. The cut-point between the high- and moderate-risk was determined to be greater than or equal to 3.5% of the 6-year baseline risk.
INTRODUCTION: We hypothesize that the incidence of screen-detected lung cancer (LC), in participants with previously negative scans, will be highest in the cohort with the highest baseline risk score. METHODS: Individuals with negative baseline screening results from the Princess Margaret International Early Lung Cancer Action Program before 2009 underwent low-dose computed tomography rescreening from 2015 to 2018. Individuals were contacted in order of descending risk, as determined by the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial's PLCOM2012 6-year LC risk-prediction model, and then categorized into three risk cohorts according to their baseline risks. The incidence of LC in each risk cohort was determined and compared. Chi-square testing was used for categorical variables and one-way analysis of variance on ranks was used for continuous variables. RESULTS: Of the 1261 participants we attempted to re-contact, 359 participants returned for a rescreening scan (mean of 7.6 years between scans). Participants were divided into low (<2%), moderate (≥2% to <3.5%), and high baseline risk (≥3.5%) cohorts. On average, those in the high-risk cohort compared to the moderate- and low-risk cohorts were older (66 years versus 62 and 59 years) and had a greater smoking history (54 pack-years versus 47 and 29 pack-years). The incidence of cancer in the high-risk cohort was significantly higher than in the moderate-risk cohort (11% versus 1.7%, p = 0.002). CONCLUSIONS: There was a significantly higher incidence of LC in the high-risk cohort than in the moderate-risk cohort. The cut-point between the high- and moderate-risk was determined to be greater than or equal to 3.5% of the 6-year baseline risk.
Authors: Jacqueline V Aredo; Eunji Choi; Victoria Y Ding; Martin C Tammemägi; Kevin Ten Haaf; Sophia J Luo; Neal D Freedman; Lynne R Wilkens; Loïc Le Marchand; Heather A Wakelee; Rafael Meza; Sung-Shim Lani Park; Iona Cheng; Summer S Han Journal: JNCI Cancer Spectr Date: 2022-05-02
Authors: Rudolf M Huber; Milena Cavic; Anna Kerpel-Fronius; Lucia Viola; John Field; Long Jiang; Ella A Kazerooni; Coenraad F N Koegelenberg; Anant Mohan; Ricardo Sales Dos Santos; Luigi Ventura; Murry Wynes; Dawei Yang; Javier Zulueta; Choon-Taek Lee; Martin C Tammemägi; Claudia I Henschke; Stephen Lam Journal: J Thorac Oncol Date: 2021-12-03 Impact factor: 15.609