Trends in lung cancer screening in the United States, 2016–2017

Okereke, Ikenna; Nishi, Shawn P.E.; Zhou, Jie; Goodwin, James S.

doi:10.21037/jtd.2019.01.105

Cited by 55 publications

(39 citation statements)

References 19 publications

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“…Although the rate of LCS seems to be increasing, 40 the current use is low and interventions focused on specific issues in communities will impact target populations with no geographic access to screening minimally. Geographic analysis should be performed routinely to identify gaps in accessibility.…”

Section: Discussionmentioning

confidence: 99%

Using Geospatial Analysis to Evaluate Access to Lung Cancer Screening in the United States

Sahar

Wills

Liu

et al. 2021

Chest

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BACKGROUND: Screening current and former heavy smokers 55 to 80 years of age for lung cancer (LC) with low-dose chest CT scanning has been recommended by the United States Preventive Services Task Force since 2013. Although the number of screening facilities in the United States has increased, screening uptake has been slow. RESEARCH QUESTION: To what extent is geographic access to screening facilities a barrier for screening uptake nationally? STUDY DESIGN AND METHODS: Screening facilities were defined as American College of Radiology (ACR) Lung Cancer Screening Registry (LCSR) facilities. Analysis was performed at different geographic levels using a road network to calculate travel distances for the recommended age groups. Full access to screening was defined as the entire 55-to 79-year-old population being within 40 miles of an ACR LCSR facility. No access was defined as lack of access by the entire target population. Partial access was expressed in intervening quartiles. A geospatial approach then was used to integrate accessibility with smoking prevalence and LC mortality rates to identify potential focus areas visually. RESULTS: Screening facilities addresses were geocoded to identify 3,592 unique locations. Analysis of census tracts and aggregation to counties revealed that among 3,142 counties, adults 55 to 79 years of age have full access to an LC screening registry facility in 1,988 (63%) counties, partial access in 587 (19%) counties, and no access in 567 (18%) counties. Overall, less than 6% of those 55 to 79 years of age do not have access to registry screening facilities. Variation in screening facility access was noted across the United States, between states, and within some states. INTERPRETATION: It is recommended to calculate accessibility using subcounty geographies and to examine variation regionally and within states. A foundation geographic accessibility layer can be integrated with other variables to identify geographic disparities in access to screening and to focus on areas for interventions. Identifying areas of greatest need can inform state and local officials and healthcare organizations when planning and implementing LC screening programs.

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Section: Discussionmentioning

confidence: 99%

Using Geospatial Analysis to Evaluate Access to Lung Cancer Screening in the United States

Sahar

Wills

Liu

et al. 2021

Chest

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“…Lung cancer is the number one cancer killer and is felt to be much more curable if detected early, making this a major public health issue. Despite this, rates of CT lung cancer screening are low [6]. This study suggests one way in which the barrier to these low rates can be breached.…”

Section: Discussionmentioning

confidence: 87%

Cancer Informatics in 2019: Deep Learning Takes Center Stage

Warner

Patt

2020

Yearb Med Inform

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Objective: To summarize significant research contributions on cancer informatics published in 2019. Methods: An extensive search using PubMed/Medline and manual review was conducted to identify the scientific contributions published in 2019 that address topics in cancer informatics. The selection process comprised three steps: (i) 15 candidate best papers were first selected by the two section editors, (ii) external reviewers from internationally renowned research teams reviewed each candidate best paper, and (iii) the final selection of two best papers was conducted by the editorial committee of the Yearbook. Results: The two selected best papers demonstrate the clinical utility of deep learning in two important cancer domains: radiology and pathology. Conclusion: Cancer informatics is a broad and vigorous subfield of biomedical informatics. Applications of new and emerging computational technologies are especially notable in 2019.

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“…At present, the wide-spread clinical implementation of LDCT is hampered by clinical and socio-economic limitations, and access and adherence to LDCT screening programmes in high-risk populations remains low [ 54 ]. New, more accessible screening methods might improve uptake and adherence.…”

Section: Discussionmentioning

confidence: 99%

Current lung cancer screening guidelines may miss high-risk population: a real-world study

Bao

et al. 2021

BMC Cancer

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Background Despite much research published on lung cancer screening, China has had no large-scale study on the missed diagnosis of lung cancer in a health examination population. We therefore did a real-world study using the current lung cancer screening guidelines to a health examination population in China to determine the proportion of lung cancer cases that have been missed. Methods A real-world cohort study of screening, with the use of low-dose computed tomography, was conducted among people who took yearly health checkup in health management center of West China Hospital between 2006 and 2017. We respectively used current guidelines including lung cancer screening guidelines of the U.S. Preventive Services Task Force (USPSTF) and expert consensus on low dose spiral CT lung cancer screening in China. Results In a total of 15,996 participants with health examination who completed the baseline screening, 6779 (42.4%) subjects had at least one positive finding, and 142 (2.1%) cases of lung cancer were screened positive. The false positive rate was 97.9%. Of 142 lung cancer cases detected in our study, only 9.2% met the lung cancer screening guidelines proposed by the USPSTF, and 24.4% met that of China. The rates of missed diagnosis were as high as 90.8 and 75.6% respectively. In addition, we did an in-depth analysis by gender. We found that among male patients with lung cancer, the proportion of smokers was 75%, and the proportion of young people under 50 was 23.2%. Among female patients with lung cancer, the proportion of smokers was only 5.8%, and the proportion of young people under 50 was up to 33.3%. Conclusions The rate of missed diagnosis was as high as 90.8% applying the current lung cancer screening guidelines to the health examination population in China. Further study to determine screening guidelines for targeted populations, is warranted.

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Trends in lung cancer screening in the United States, 2016–2017

Cited by 55 publications

References 19 publications

Using Geospatial Analysis to Evaluate Access to Lung Cancer Screening in the United States

Using Geospatial Analysis to Evaluate Access to Lung Cancer Screening in the United States

Cancer Informatics in 2019: Deep Learning Takes Center Stage

Current lung cancer screening guidelines may miss high-risk population: a real-world study

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