Stage I lung cancer patients with or without symptoms – are the patients different and should we treat them differently?

Bredtoft, Ebbe; Madsen, Harold S.; Rasmussen, Torben Riis

doi:10.1080/0284186x.2021.1931959

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…As previously found, the majority of early-stage lung cancer is diagnosed as the result of the incidental discovery of pulmonary nodules [ 20 ]. Hence, given that Region Zealand has lower rates of early-stage lung cancer and lower overall survival compared to other Danish regions, the absence of a correlation between CT usage and the proportion of early-stage lung cancers could lead to the hypothesis that lack of identification and/or monitoring of IPNs (representing small, early-stage lung cancers) led to a less favorable stage distribution with poorer prognosis and survival rates.…”

Section: Discussionmentioning

confidence: 99%

Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this

Borg,

Bodtger,

Kristensen

et al. 2024

European Clinical Respiratory Journal

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Background The management of pulmonary nodules plays a critical role in early detection of lung cancer. Computed tomography (CT) has led to a stage-shift towards early-stage lung cancer, but regional differences in survival rates have been reported in Denmark. This study aimed to evaluate whether variations in nodule management among Danish health regions contributed to these differences. Material and Methods The Danish Health Data Authority and Danish Lung Cancer Registry provided data on CT usage and lung cancer stage distribution, respectively. Auditing of lung cancer stage IA patient referrals and nodule management of stage IV lung cancer patients was conducted in seven Danish lung cancer investigation centers, covering four of the five Danish health regions. CT scans were performed up to 2 years before the patients’ diagnosis from 2019 to 2021. Results CT usage has increased steadily in Denmark over the past decade, with a simultaneous increase in the proportion of early-stage lung cancers, particularly stage IA. However, one Danish health region, Region Zealand, exhibited lower rates of early-stage lung cancer and overall survival despite a CT usage roughly similar to that of the other health regions. The audit did not find significant differences in pulmonary nodule management or a higher number of missed nodules by radiologists in this region compared to others. Conclusion This study suggests that a high CT scan volume alone is not sufficient for the early detection of lung cancer. Factors beyond hospital management practices, such as patient-related delays in socioeconomically disadvantaged areas, may contribute to regional differences in survival rates. This has implications for future strategies for reducing these differences.

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Section: Discussionmentioning

confidence: 99%

Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this

Borg,

Bodtger,

Kristensen

et al. 2024

European Clinical Respiratory Journal

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“…We suggested that for patients with early-stage lung cancer, the duration of DTI was not related to the severity of symptoms. Some studies showed that about half of the early patients were found by accident and had no relevant symptoms [ 40 ]. Patients with stage IA lung cancer generally did not have obvious symptoms, so it was unlikely to choose treatment as soon as possible due to the suffering of tumor, as patients with advanced stage lung cancer did.…”

Section: Discussionmentioning

confidence: 99%

Survival analysis and clinicopathological features of patients with stage IA lung adenocarcinoma

Li,

Wang,

Liu

et al. 2024

Heliyon

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“…Currently, it is not known whether increased use of CT is related to a higher fraction of early-stage lung cancer. It does, however, seem plausible since previous studies have found that the majority of stage I lung cancer cases are incidental findings (6,7). Furthermore, if the majority of early-stage lung cancer cases are incidental findings, it becomes highly important to ensure management and follow-up of incidental pulmonary findings in accordance with current guidelines (71).…”

Section: Ct Exams and Lung Cancer Stage Distributionmentioning

confidence: 99%

“…Lung cancer symptoms depend on the stage of the disease. Classical pulmonary symptoms of lung cancer are cough, shortness of breath, hemoptysis, thoracic pain and hoarseness, while constitutional symptoms are predominantly fatigue, weight loss and night sweats (6). In early-stage lung cancer, a large proportion of patients have no symptoms and the finding is often incidental (6).…”

Section: Symptoms Of Lung Cancermentioning

confidence: 99%

“…Classical pulmonary symptoms of lung cancer are cough, shortness of breath, hemoptysis, thoracic pain and hoarseness, while constitutional symptoms are predominantly fatigue, weight loss and night sweats (6). In early-stage lung cancer, a large proportion of patients have no symptoms and the finding is often incidental (6). Previous research shows that overall survival proved better in patients without symptoms compared to symptomatic lung cancer patients (7,8).…”

Section: Symptoms Of Lung Cancermentioning

confidence: 99%

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Early Detection of Lung Cancer: Biomarkers and CT Scans

Borg¹

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show abstract

Stage I lung cancer patients with or without symptoms – are the patients different and should we treat them differently?

Cited by 6 publications

References 6 publications

Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this

Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this

Survival analysis and clinicopathological features of patients with stage IA lung adenocarcinoma

Early Detection of Lung Cancer: Biomarkers and CT Scans

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