Sarah Singh1, Flaminio Pavesi1, Katrina Steiling2, Sainath Asokan1, Cisco Espinosa1, Howard J Cabral3, Eric J Burks4, Amanda Meister5, Ogheneyoma Akpoviroro5, Anne Buck1, Kelly Drozdowicz1, Virginia R Litle5, Kei Suzuki6. 1. Boston University School of Medicine, Boston, MA. 2. Division of Pulmonary Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA. 3. Department of Biostatistics, Boston University School of Public Health, Boston, MA. 4. Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA. 5. Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA. 6. Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA. Electronic address: kei.suzuki@bmc.org.
Abstract
INTRODUCTION/ BACKGROUND: The USPSTF (United States Preventive Services Task Force) guidelines suggest criteria centering on smoking status and age to select patients for lung cancer screening. Despite the significant advances in screening with low-dose computed tomography (LDCT), cancer detection rate is low (1.1%), highlighting the need to investigate possible ways to refine the current lung cancer screening strategy. Our aim was to determine clinical risk factors predictive of lung cancer in an urban safety-net hospital. MATERIALS AND METHODS: We performed a retrospective chart review of 2847 patients who received LDCT screening for lung cancer between 3/1/2015 and 12/31/2019. Patient demographics and medical history were collected. A bivariate logistic regression was used to evaluate predictors of lung cancer. RESULTS: Compared to the National Lung Cancer Screening Trial (NLST) population, our screening cohort had significantly more African Americans (38.2% vs. 4.5%, P < .0001), more obesity (32.7% vs. 28.3%, P < .0001), and higher rates of chronic obstructive pulmonary disease (COPD) (45.9% vs. 5.0%, P < .0001). The strongest predictors of lung cancer were COPD (odds ratio [OR] = 2.14, P < .0001) and a family history of lung cancer (OR = 2.77, P < .0001). Age (OR = 1.04, P< .001) and pack years (OR = 1.01, P< .001) were less predictive. CONCLUSION: A diagnosis of COPD and family history of lung cancer were most predictive of lung cancer in a screening cohort at our urban safety-net hospital. Future studies should focus on whether inclusion of these additional risk-factors improves proportion of lung cancer detected via screening.
INTRODUCTION/ BACKGROUND: The USPSTF (United States Preventive Services Task Force) guidelines suggest criteria centering on smoking status and age to select patients for lung cancer screening. Despite the significant advances in screening with low-dose computed tomography (LDCT), cancer detection rate is low (1.1%), highlighting the need to investigate possible ways to refine the current lung cancer screening strategy. Our aim was to determine clinical risk factors predictive of lung cancer in an urban safety-net hospital. MATERIALS AND METHODS: We performed a retrospective chart review of 2847 patients who received LDCT screening for lung cancer between 3/1/2015 and 12/31/2019. Patient demographics and medical history were collected. A bivariate logistic regression was used to evaluate predictors of lung cancer. RESULTS: Compared to the National Lung Cancer Screening Trial (NLST) population, our screening cohort had significantly more African Americans (38.2% vs. 4.5%, P < .0001), more obesity (32.7% vs. 28.3%, P < .0001), and higher rates of chronic obstructive pulmonary disease (COPD) (45.9% vs. 5.0%, P < .0001). The strongest predictors of lung cancer were COPD (odds ratio [OR] = 2.14, P < .0001) and a family history of lung cancer (OR = 2.77, P < .0001). Age (OR = 1.04, P< .001) and pack years (OR = 1.01, P< .001) were less predictive. CONCLUSION: A diagnosis of COPD and family history of lung cancer were most predictive of lung cancer in a screening cohort at our urban safety-net hospital. Future studies should focus on whether inclusion of these additional risk-factors improves proportion of lung cancer detected via screening.
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