Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program

LeMense, Gregory P.; Waller, E. Andrew; Campbell, C. P.; Bowen, Tyler

doi:10.21203/rs.2.18446/v1

Cited by 8 publications

(27 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consequently, this screening method has been accepted by the academic community and included in clinical guidelines. With large-scale CT screening, an increasing number of unidentified lung lesions appears to be occurring (4,5). Therefore, the optimal diagnostic approach for patients with suspicious nodules urgently needs to be determined.…”

Section: Introductionmentioning

confidence: 99%

Radial endobronchial ultrasound-assisted transbronchial needle aspiration for pulmonary peripheral lesions in the segmental bronchi adjacent to the central airway

Song

Yang

Wang

et al. 2021

Transl Lung Cancer Res

View full text Add to dashboard Cite

Background: Tissue samples from lesions located in the 3rd to 5th segmental bronchi are challenging to obtain. In this retrospective study, we aimed to evaluate the diagnostic rate of pulmonary peripheral lesions located in the 3rd to 5th segmental bronchi, near the inner field of lung on the computed tomography (CT) image and outside the bronchus, using radial endobronchial ultrasound (REBUS) followed by transbronchial needle aspiration (TBNA).Methods: This retrospective study enrolled patients whose preoperative CT examinations showed a lesion located in the segmental bronchi (3rd to 5th), yet adjacent to the inner field of lung on the CT image.REBUS followed by TBNA was used to acquire tissue samples from these lesions. A bronchoscope was used to reach the bronchi surrounding the lesion, and an ultrasound probe was used to determine the lesion's location. Then, the ultrasound probe was withdrawn, and puncture was performed at the location that was determined by ultrasound. The tissue specimens obtained were subjected to pathological examination.Results: Nineteen patients were enrolled in this study including 15 males and 4 females with an average age of 55 years old. Of the enrollees, 8 patients (42.1%) were successfully diagnosed with samples obtained through TBNA, including 6 cases of lung cancer, 1 case of non-specific inflammation, and 1 case of cryptococcal infection. The diagnostic rate was 42.1%. No post-procedural complications were observed among the patients. There was no significant difference in nodule diameter between patients with a diagnostic sample and those in whom TBNA failed to provide a diagnosis (2.99±0.96 vs. 2.26±1.27 cm, P=0.20).Conclusions: With the assistance of REBUS, TBNA can acquire sufficient samples to achieve a reasonably diagnostic rate for parenchymal lung lesions located near the inner field of lung on the CT image without intrabronchial invasion.

show abstract

Section: Introductionmentioning

confidence: 99%

Radial endobronchial ultrasound-assisted transbronchial needle aspiration for pulmonary peripheral lesions in the segmental bronchi adjacent to the central airway

Song

Yang

Wang

et al. 2021

Transl Lung Cancer Res

View full text Add to dashboard Cite

show abstract

“…The studies rated with the highest quality and strength supported that smoking history was associated with an increased risk of lung cancer. The literature review confirmed the decision to adopt the 2013 USPSTF recommendations 20–25…”

Section: Methodsmentioning

confidence: 74%

Improving Lung Cancer Screening Rates Through an Evidence-Based Electronic Health Record Smoking History

Russell

McNeill

2022

Journal of Nursing Care Quality

View full text Add to dashboard Cite

Background: Lung cancer is prevalent worldwide, with 2.1 million new cases and 1.8 million deaths in 2020. In the United States, an estimated 131 880 lung cancer deaths are expected to occur in 2021, with most detected in later stages. Smokers are 15 to 30 times more likely to develop or die from lung cancer. Local Problem: Our community residents were more likely to be diagnosed with lung cancer in later stages (62%) compared with 56% nationally, resulting in an increased community mortality rate. Intervention: Evidence-based changes in an electronic health record system supported identification and referral of high-risk patients for low-dose computer tomography to improve early lung cancer detection rates. Results: Early-stage lung cancer detection increased 24%. Conclusions: Interprofessional teams used technology to adopt evidence-based practice and improve health outcomes in their communities.

show abstract

“…In most cases, no growth is observed after one or two additional scans and malignancy can be ruled out. Only in about 2% of patients an invasive diagnostic test becomes necessary during follow-up, leading to the diagnosis of a lung cancer in approximately half of them [16]. The burden of additional tests with routine preoperative CT thus consists mainly of additional non-invasive follow-up.…”

Section: Discussionmentioning

confidence: 99%

Incidental findings on routine preoperative noncontrast chest computed tomography and chest radiography prior to cardiac surgery in the multicenter randomized controlled CRICKET study

et al. 2022

View full text Add to dashboard Cite

Objective To describe the prevalence and consequences of incidental findings when implementing routine noncontrast CT prior to cardiac surgery. Methods In the multicenter randomized controlled CRICKET study, 862 adult patients scheduled for cardiac surgery were randomized 1:1 to undergo standard of care (SoC), which included a chest-radiograph, or an additional preoperative noncontrast chest CT-scan (SoC+CT). In this subanalysis, all incidental findings detected on the chest radiograph and CT-scan were analyzed. The influence of smoking status on incidental findings was also evaluated, adjusting for sex, age, and group allocation. Results Incidental findings were observed in 11.4% (n = 49) of patients in the SoC+CT group and in 3.7% (n = 16) of patients in the SoC-group (p < 0.001). The largest difference was observed in findings requiring follow-up (SoC+CT 7.7% (n = 33) vs SoC 2.3% (n = 10), p < 0.001). Clinically relevant findings changing the surgical approach or requiring specific treatment were observed in 10 patients (1.2%, SoC+CT: 1.6% SoC: 0.7%), including lung cancer in 0.5% of patients (n = 4) and aortic dilatation requiring replacement in 0.2% of patients (n = 2). Incidental findings were more frequent in patients who stopped smoking (OR 1.91, 1.03–3.63) or who actively smoked (OR 3.91, 1.85–8.23). Conclusions Routine CT-screening increases the rate of incidental findings, mainly by identifying more pulmonary findings requiring follow-up. Incidental findings are more prevalent in patients with a history of smoking, and preoperative CT might increase the yield of identifying lung cancer in these patients. Incidental findings, but not specifically the use of routine CT, are associated with delay of surgery. Key Points • Clinically relevant incidental findings are identified more often after a routine preoperative CT-scan, when compared to a standard of care workup, with some findings changing patient management. • Patients with a history of smoking have a higher rate of incidental findings and a lung cancer rate comparable to that of lung cancer screening trials. • We observed no clear delay in the time to surgery when adding routine CT screening.

show abstract

Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program

Cited by 8 publications

References 23 publications

Radial endobronchial ultrasound-assisted transbronchial needle aspiration for pulmonary peripheral lesions in the segmental bronchi adjacent to the central airway

Radial endobronchial ultrasound-assisted transbronchial needle aspiration for pulmonary peripheral lesions in the segmental bronchi adjacent to the central airway

Improving Lung Cancer Screening Rates Through an Evidence-Based Electronic Health Record Smoking History

Incidental findings on routine preoperative noncontrast chest computed tomography and chest radiography prior to cardiac surgery in the multicenter randomized controlled CRICKET study

Contact Info

Product

Resources

About