Diagnostic work-up and surgery in participants of the Gdansk lung cancer screening programme: the incidence of surgery for non-malignant conditions

Rzyman, Witold; Jelitto-Górska, Małgorzata; Dziedzic, Robert; Biadacz, Iwona; Książek, Janina; Chwirot, Piotr; Marjański, Tomasz

doi:10.1093/icvts/ivt388

Cited by 28 publications

(22 citation statements)

References 25 publications

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“…One-fourth of the surgical patients underwent futile thoracotomies. 24 This number should definitely be reduced, although it does not differ substantially from that observed in our daily practice. During this same period, 20% of patients with nonmalignant lesions underwent surgery in our department, outside the screening program.…”

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confidence: 56%

Results of an open-access lung cancer screening program with low-dose computed tomography: the Gdańsk experience

Rzyman¹,

Dziedzic²,

Jelitto-Górska³

et al. 2015

Polish Archives of Internal Medicine

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INTRODUCTION Lung cancer screening with low-dose computed tomography (LDCT) is one of the most promising tools for reducing mortality from lung cancer. OBjeCTIves The aim of the study was to evaluate the results of an open-access lung cancer screening program with LDCT. PATIeNTs AND meThODs In total, 8649 asymptomatic volunteers between 50 and 75 years of age with a smoking history of at least 20 pack-years underwent LDCT screening. The presence of lung nodules with a diameter of less than 5 mm required a follow-up control visit after 12 months, and with a diameter of 5 to 10 mm-after 3, 6, and 12 months. Patients with a nodule of more than 10 mm in diameter required further diagnostic workup. ResUlTs Lung nodules were detected in 4694 individuals (54%). Lung cancer was diagnosed in 107 patients (1.24%). Of 8649 participants, 300 (3.5%) were referred for further diagnostic workup, and 125 (1.5%) underwent surgical resection (81 because of malignant lesions; 44, benign lesions). Eighty-one participants (75%) underwent surgery with a curative intent, and 26 participants underwent oncological treatment. There were no perioperative deaths. The majority of surgical patients underwent lobectomy (video-assisted, in 30 patients; and open, in 38 patients). Stage I non-small cell lung cancer was detected in 64 of the surgical patients (79%). CONClUsIONs The detection rate of lung cancer in the screening program with low-dose computed tomography is relatively low but patients were diagnosed at a very early stage of the disease compared with standard clinical practice.

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confidence: 56%

Results of an open-access lung cancer screening program with low-dose computed tomography: the Gdańsk experience

Rzyman¹,

Dziedzic²,

Jelitto-Górska³

et al. 2015

Polish Archives of Internal Medicine

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“…Procedure rates in other reviewed studies varied in part based on trial length and design (1.2%-6.8%). 16,19,39,51,61 In total, three studies described procedure rates in those screened with CXR, and 17 studies in those screened with LDCT; 2.7% of those screened with CXR and 5.1% with LDCT had an invasive procedure performed (e -Fig 2A, 2B). A balance must be considered when reviewing data about procedures for screen-detected nodules.…”

Section: Harms Of Screening For Lung Cancermentioning

confidence: 99%

Screening for Lung Cancer

Mazzone

Silvestri

Patel

et al. 2018

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277

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“…However, relatively low positive predictive value and sensitivity of this test may lead to "over-diagnosis". In our own experience, around 75% of patients with screening-detected lung abnormalities underwent unnecessary diagnostic work-up, including around 25% of patients subjected to further invasive procedures (Rzyman et al, 2013). For these reasons, complementation of CT-based screening with other tests allowing effective and reliable preselection of individuals for LD-CT examination, or better discrimination between benign and malignant nodules detected by LD-CT, seems a critical issue for practical application of this strategy (Priola et al, 2013;Rzyman et al, 2015).…”

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confidence: 99%

Panel of serum metabolites discriminates cancer patients and healthy participants of lung cancer screening - a pilot study

et al. 2017

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Diagnostic work-up and surgery in participants of the Gdansk lung cancer screening programme: the incidence of surgery for non-malignant conditions

Abstract: Futile diagnostic work-ups and operations must be reduced before LDCT screening can be broadly used. Stage I adenocarcinoma dominated in the NSCLC patients who underwent surgery.

Cited by 28 publications

References 25 publications

Results of an open-access lung cancer screening program with low-dose computed tomography: the Gdańsk experience

Results of an open-access lung cancer screening program with low-dose computed tomography: the Gdańsk experience

Screening for Lung Cancer

Panel of serum metabolites discriminates cancer patients and healthy participants of lung cancer screening - a pilot study

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