CT screening for lung cancer: Importance of emphysema for never smokers and smokers

Henschke, Claudia I.; Yip, Rowena; Boffetta, Paolo; Markowitz, Steven; Miller, Albert; Hanaoka, Takaomi; Wu, Ning; Zulueta, Javier; Yankelevitz, David F.

doi:10.1016/j.lungcan.2015.01.014

Cited by 83 publications

(46 citation statements)

References 25 publications

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“…The prevalence of COPD in our study is consistent with some previous results, but slightly lower than others [12, 13, 34]. Even so, we found high rates of underdiagnosis (71.6%), consistent with the available data from other series [34-37].…”

Section: Discussionsupporting

confidence: 93%

“…The remaining smokers were classiﬁed as ex-smokers. Never smokers were deﬁned as having smoked less than 100 cigarettes in their lifetime [12]. Spirometry was performed at the LC diagnosis by a technician specialized in respiratory functional tests.…”

Section: Methodsmentioning

confidence: 99%

“…The prevalence of COPD among LC patients is unclear, although it seems to affect at least 28–40% [12-14]. Also, the underdiagnosis of COPD is quite high in most series, including patients with LC, some studies having reported a previous diagnosis of COPD in 7.1% of LC patients [15].…”

Section: Introductionmentioning

confidence: 99%

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Chronic Obstructive Pulmonary Disease in Lung Cancer Patients: Prevalence, Underdiagnosis, and Clinical Characterization

et al. 2018

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Background: Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) are associated with increased morbidity and mortality. The differential clinical and functional features among LC patients with or without COPD have not been defined. Objectives: The aims of this study were to examine the prevalence and underdiagnosis rate of COPD in LC patients and to compare the clinical and functional features of LC patients with and without COPD. Methods: We designed a multicenter hospital-based study including all LC cases diagnosed from January 2014 to August 2016. We assessed epidemiological, clinical, radiological, functional, and histological variables in all cases. Results: We recruited 602 patients with LC, most of them men (77.9%), with a median age of 67 ± 15 years. The COPD prevalence among LC patients was 51.5%, with a underdiagnosis rate of 71.6%. The LC+COPD patients were older and the proportion of men was higher compared with the LC-only patients. The LC+COPD patients had more pack-years, more squamous LC, a lower monoxide transfer coefficient (KCO), and higher Charlson index scores than patients with LC only. The median survival of LC-only patients was 37% longer than that of LC+COPD patients (22 vs. 16 months), but this difference was not statistically significant. Conclusions: Among LC patients, COPD is prevalent and underdiagnosed. Patients with LC+COPD more often have squamous LC, have greater comorbidities, and have a lower KCO. More effort should be made for an early diagnosis of COPD to select patients at higher risk of developing LC.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

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Chronic Obstructive Pulmonary Disease in Lung Cancer Patients: Prevalence, Underdiagnosis, and Clinical Characterization

et al. 2018

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“…COPD and interstitial lung disease are also strong risk factors for lung cancer [21][22][23] . Henschke et al [24] found that the prevalence of lung cancer increased among those who had CT evidence of emphysema immaterial of smoking status. In our study, malignant nodules tended to have severe regional emphysema and fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Performance comparison of quantitative semantic features and lung-RADS in the National Lung Screening Trial

Balagurunathan

Liu

et al. 2016

SPIE Proceedings

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Background: Lung-RADS is the new oncology classification guideline proposed by American College of Radiology (ACR), which provides recommendation for further follow up in lung cancer screening. However, only two features (solidity and size) are included in this system. We hypothesize that additional sematic features can be used to better characterize lung nodules and diagnose cancer. Objective: We propose to develop and characterize a systematic methodology based on semantic image traits to more accurately predict occurrence of cancerous nodules. Methods: 24 radiological image traits were systematically scored on a point scale (up to 5) by a trained radiologist, and lung-RADS was independently scored. A linear discriminant model was used on the semantic features to access their performance in predicting cancer status. The semantic predictors were then compared to lung-RADS classification in 199 patients (60 cancers, 139 normal controls) obtained from the National Lung Screening Trial. Result: There were different combinations of semantic features that were strong predictors of cancer status. Of these, contour, border definition, size, solidity, focal emphysema, focal fibrosis and location emerged as top candidates. The performance of two semantic features (short axial diameter and contour) had an AUC of 0.945, and was comparable to that of lung-RADS (AUC: 0.871). Conclusion: We propose that a semantics-based discrimination approach may act as a complement to the lung-RADS to predict cancer status.

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“…b Major benefits in terms of reduction of other smoking-related diseases; the potential to utilise lung CT screening to diagnose coronary artery calcification, COPD [31,32,33], and potentially in breast cancer and spinal stenosis. Further research is required to direct EU policy on these added benefits.…”

Section: Resource Allocation Which Maximizes the Eu Commission Actiomentioning

confidence: 99%

EU Policy on Lung Cancer CT Screening 2017

Field

Zulueta²,

Veronesi

et al. 2017

Biomed Hub

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Background: Lung cancer kills more Europeans than any other cancer. In 2013, 269,000 citizens of the EU-28 died from this disease. Lung cancer CT screening has the potential to detect lung cancer at an early stage and improve mortality. All of the randomised controlled trials and cohort low-dose CT (LDCT) screening trials across the world have identified very early stage disease (∼70%); the majority of these LDCT trial patients were suitable for surgical interventions and had a good clinical outcome. The 10-year survival in CT screen-detected cancer was shown to be even higher than the 5-year survival for early stage disease in clinical practice at 88%. Methods: Setting up of an EU Commission expert group can be done under Article 168(2) of the Treaty on the Functioning of the European Union, to develop policy and recommendation for Lung cancer CT screening. The Expert Group would undertake: (a) assist the Commission in the drawing up policy documents, including guidelines and recommendations; (b) advise the Commission in the implementation of Union actions on screening and suggest improvements to the measures taken; (c) advise the Commission in the monitoring, evaluation and dissemination of the results of measures taken at Union and national level. Results: This EU Expert Group on lung cancer screening should be set up by the EU Commission to support the implementation and suggest recommendations for the lung cancer screening policy by 2019/2020. Conclusion: Reduce lung cancer in Europe by undertaking a well-organised lung cancer CT screening programme.

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CT screening for lung cancer: Importance of emphysema for never smokers and smokers

Abstract: Identification of emphysema in low-dose CT scans increases the risk of lung cancer and is important in determining follow-up of current, former, and never smokers.

Cited by 83 publications

References 25 publications

Chronic Obstructive Pulmonary Disease in Lung Cancer Patients: Prevalence, Underdiagnosis, and Clinical Characterization

Chronic Obstructive Pulmonary Disease in Lung Cancer Patients: Prevalence, Underdiagnosis, and Clinical Characterization

Performance comparison of quantitative semantic features and lung-RADS in the National Lung Screening Trial

EU Policy on Lung Cancer CT Screening 2017

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