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CT screening for lung cancer: comparison of three baseline screening protocols.

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Title: CT screening for lung cancer: comparison of three baseline screening protocols.
Authors: Henschke, Claudia I.1,2,3 Claudia.Henschke@mountsinai.org, Yip, Rowena1, Ma, Teng1,4, Aguayo, Samuel M.2, Zulueta, Javier5, Yankelevitz, David F.1, Writing Committee for the I-ELCAP Investigators (CORPORATE AUTHOR)
Source: European Radiology. Oct2019, Vol. 29 Issue 10, p5217-5226. 10p. 4 Charts, 1 Graph.
Subjects: Lung cancer, Early detection of cancer, Decision making, Cancer diagnosis, Evaluation research, Computed tomography, Lung tumors, Research methodology, Research, Medical screening, Comparative studies, Algorithms
Abstract: Purpose: Clinical management decisions arising from the baseline round for lung cancer screening are the most challenging, as findings have accumulated over a lifetime and may be of no clinical concern. To minimize unnecessary harms and costs of workup prior to the first, annual repeat screening, workup should be limited to participants with the highest suspicion of lung cancer while still aiming to identify small, early lung cancers.Methods: We compared recommendations for immediate, delayed (by 3 or 6 months) workup to assess growth at a malignant rate, and the resulting overall and potential biopsies of three baseline screening protocols: I-ELCAP, the two scenarios of ACR-LungRADS, and the European Consortium. For each protocol, the efficiency ratio (ER) of each recommendation was calculated by dividing the number of participants recommended for that workup by the number of resulting lung cancer diagnoses. The ER for potential biopsies was calculated, assuming that biopsies were performed on all participants recommended for immediate workup as well as those diagnosed with lung cancer after delayed workup.Results: For I-ELCAP, ACR-LungRADS Scenario 1, ACR-LungRADS Scenario 2, and the European consortium, the overall ER was 13.9, 18.3, 18.3, and 31.9, respectively, and for potential biopsies, it was 2.2, 8.1, 3.2, and 4.4, respectively. ER for immediate workup was 2.9, 8.6, 3.9, and 5.6, respectively, and for delayed workup was 36.1, 160.3, 57.8, and 111.9, respectively.Conclusions: I-ELCAP recommendations had the lowest ER values for overall, immediate, and delayed workup, and for potential biopsies.Key Points: • Small differences in protocol thresholds can lead to many unnecessary diagnostic workups. • I-ELCAP recommendations were the most efficient for immediate and overall workup, and potential biopsies. • Definition of a "positive result" and recommendations for further workup in the baseline round needs to be continually reevaluated and updated. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: CT screening for lung cancer: comparison of three baseline screening protocols.
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  Data: <searchLink fieldCode="AR" term="%22Henschke%2C+Claudia+I%2E%22">Henschke, Claudia I.</searchLink><relatesTo>1,2,3</relatesTo><i> Claudia.Henschke@mountsinai.org</i><br /><searchLink fieldCode="AR" term="%22Yip%2C+Rowena%22">Yip, Rowena</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Ma%2C+Teng%22">Ma, Teng</searchLink><relatesTo>1,4</relatesTo><br /><searchLink fieldCode="AR" term="%22Aguayo%2C+Samuel+M%2E%22">Aguayo, Samuel M.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Zulueta%2C+Javier%22">Zulueta, Javier</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Yankelevitz%2C+David+F%2E%22">Yankelevitz, David F.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Writing+Committee+for+the+I-ELCAP+Investigators%22">Writing Committee for the I-ELCAP Investigators</searchLink> (CORPORATE AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Oct2019, Vol. 29 Issue 10, p5217-5226. 10p. 4 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Lung+cancer%22">Lung cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Early+detection+of+cancer%22">Early detection of cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Decision+making%22">Decision making</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+diagnosis%22">Cancer diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+research%22">Evaluation research</searchLink><br /><searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Lung+tumors%22">Lung tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+screening%22">Medical screening</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Algorithms%22">Algorithms</searchLink>
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  Data: <bold>Purpose: </bold>Clinical management decisions arising from the baseline round for lung cancer screening are the most challenging, as findings have accumulated over a lifetime and may be of no clinical concern. To minimize unnecessary harms and costs of workup prior to the first, annual repeat screening, workup should be limited to participants with the highest suspicion of lung cancer while still aiming to identify small, early lung cancers.<bold>Methods: </bold>We compared recommendations for immediate, delayed (by 3 or 6 months) workup to assess growth at a malignant rate, and the resulting overall and potential biopsies of three baseline screening protocols: I-ELCAP, the two scenarios of ACR-LungRADS, and the European Consortium. For each protocol, the efficiency ratio (ER) of each recommendation was calculated by dividing the number of participants recommended for that workup by the number of resulting lung cancer diagnoses. The ER for potential biopsies was calculated, assuming that biopsies were performed on all participants recommended for immediate workup as well as those diagnosed with lung cancer after delayed workup.<bold>Results: </bold>For I-ELCAP, ACR-LungRADS Scenario 1, ACR-LungRADS Scenario 2, and the European consortium, the overall ER was 13.9, 18.3, 18.3, and 31.9, respectively, and for potential biopsies, it was 2.2, 8.1, 3.2, and 4.4, respectively. ER for immediate workup was 2.9, 8.6, 3.9, and 5.6, respectively, and for delayed workup was 36.1, 160.3, 57.8, and 111.9, respectively.<bold>Conclusions: </bold>I-ELCAP recommendations had the lowest ER values for overall, immediate, and delayed workup, and for potential biopsies.<bold>Key Points: </bold>• Small differences in protocol thresholds can lead to many unnecessary diagnostic workups. • I-ELCAP recommendations were the most efficient for immediate and overall workup, and potential biopsies. • Definition of a "positive result" and recommendations for further workup in the baseline round needs to be continually reevaluated and updated. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-018-5857-5
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      – SubjectFull: Lung cancer
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