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Lung Cancer Screening: A Need to Re-evaluate the Current Eligibility Criteria

Chest(2015)

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摘要
SESSION TITLE: Lung Cancer Screening & Diagnosis Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: The United States Preventive Services Task Force guidelines for lung cancer screening include patients at least 55 years of age with a strong history of tobacco use. These eligibility criteria do not adequately capture the full array of vulnerable subgroups that comprise the at-risk population. The purpose of this investigation is to provide new data on younger individuals who may be at increased risk for developing lung cancer. METHODS: The Center for Lung Cancer Screening and Prevention (CLCSP) at the Stony Brook Cancer Center has adopted the (more inclusive) National Comprehensive Cancer Network (NCCN) criteria for lung cancer screening. The NCCN criteria include patients 50 years of age or older who have an additional known risk factor for lung cancer and a moderate smoking history. Lung cancer status, stratified by age group (50-54 years vs. 55-80 years), for patients attending the CLCSP are presented. RESULTS: Among the 266 CLCSP patients screened to date, 44 (16.5%) were 50-54 years of age and 2 (4.5%) were found to have lung cancer. Both patients were diagnosed with adenocarcinoma; one stage 1A and the other stage 1B. Of the 222 patients between the ages of 55 and 80 years, lung cancer was detected in 3 (1.4%) individuals. All 3 patients were stage 1A; 1 squamous and 2 adenocarcinomas. CONCLUSIONS: These findings suggest that not only does the younger cohort of patients warrant further consideration for lung cancer screening but additionally suggests that those aged 50-54 years may be more likely to develop cancer than individuals 55+ years with a stronger smoking history. Additional investigations are needed to provide the necessary evidence base for defining eligibility criteria that fully capture the at-risk population for lung cancer screening. CLINICAL IMPLICATIONS: Early detection of disease is our best defense against combatting the exceedingly high mortality rates associated with lung cancer. Identifying at-risk subgroups that would benefit from lung cancer screening has far-reaching individual, economic and healthcare system implications. DISCLOSURE: The following authors have nothing to disclose: April Plank, Denise Albano, Barbara Nemesure No Product/Research Disclosure Information
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