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

Abstract

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.

Immunoexpression analysis of selected JAK/STAT pathway molecules in non-small cell lung cancer patients

“…We looked for JAK/STAT pathway molecules whose modified immunoexpression could have diagnostic or prognostic value in lung cancer and would support clinicians in their daily practice. 23,24 Our results confirmed the increased levels of STATs, namely pSTAT3, pSTAT5, and pSTAT6, in NSCLC specimens and suggested their importance in lung carcinogenesis. The simultaneous overexpression of proteins was observed in nearly 70% of tumor samples and was similarly high, regardless of the NSCLC histotype (SCC or NSCC).…”

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

“…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). Blood is the most available source of biomarkers potentially enhancing the power of early lung cancer detection or differentiating lung nodules.…”

Consensus Statement on a Screening Programme for the Detection of Early Lung Cancer in Poland

“…Lung cancer in stage I was 64 to 70% of detected cancers. The results of these studies have highlighted the scale of tobacco smoking in the Polish population, indicated the growing awareness of the risk of lung cancer in the society and confirmed the efficacy of LDCT in detecting pulmonary nodules [39,40].…”