AT CHEST 2016

LOS ANGELES (FRONTLINE MEDICAL NEWS)Lung cancer screening with low-dose CT scans in a community hospital setting replicates results from international and multicenter trials when it comes to diagnosing early-stage lung cancer, findings from a single-center study showed.

“It’s too early in our experience to say that we’re saving lives, but the fact that we’re detecting early lung cancers in the predicted percentages is good for community hospitals that are wondering, ‘Is it worth it to screen for lung cancer? Can we do it?’ ” Richard P. Salzano Jr., MD, said in an interview in advance of the annual meeting of the American College of Chest Physicians.

Results from the International Early Lung Cancer Action Program ( I-ELCAP ), showed that with lung cancer screening, 80% of lung cancers diagnosed within a program would be stage I disease, while the National Lung Screening Trial ( NLST ), sponsored by the National Cancer Institute, documented a 20% reduction in death from lung cancer with low-dose CT screening, compared with routine chest radiography. “However, there is a history of studies that are done in large centers, or multicenter studies, not translating well to a community hospital setting,” said Dr. Salzano, chairman of the Griffin Hospital department of surgery, Derby, Conn. “We wanted to take a look at our experience with lung cancer screening and how it fits into the findings and recommendations from the large center or multicenter studies.”

In July 2013, the 130-bed Griffin Hospital launched a lung cancer screening program codirected by a pulmonologist and a cardiothoracic surgeon. All low-dose CT scans were read by two designated radiologists. Dr. Salzano reported results from 514 patients enrolled in the program between July 2013 and December 2015. A total of nine lung cancers were detected. Seven (78%) were stage I or II lung cancers, and the remaining two (22%) were stage II or IV, results that are in line with data from the I-ELCAP and NLST trials.

In another component of the study, the researchers randomly selected 101 patients from the lung cancer screening program to answer questions by telephone intended to quantify their anxiety about lung cancer before and after participating in the program, attitudes about smoking behaviors, and general impressions of the screening process. On a scale of 0-10, with 10 being “very anxious,” Dr. Salzano reported that the mean anxiety level about lung cancer fell from a level of 4.69 before screening to 3.87 afterward, a difference that reached statistical significance, with a P value of .014. “None of the patients reported negative impacts of the program,” he added. “They reported a general improvement in their well-being as a result of participating in the program.” In addition, of the 53 respondents who were current smokers upon enrolling in the screening program, five quit after intake, and the remaining 48 indicated that they were “more likely to quit” as a result of being enrolled.

“Community hospitals need to embrace lung screening,” Dr. Salzano concluded. “The findings from the large studies are transferable. It’s helping your patients in terms of their attitudes about lung cancer, about smoking cessation, and about improving their wellness.”

He reported having no relevant financial disclosures.

dbrunk@frontlinemedcom.com

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