TY - JOUR
T1 - Use of Imaging and Diagnostic Procedures After Low-Dose CT Screening for Lung Cancer
AU - Nishi, Shawn P.E.
AU - Zhou, Jie
AU - Okereke, Ikenna
AU - Kuo, Yong Fang
AU - Goodwin, James
N1 - Funding Information:
FUNDING/SUPPORT: This study was supported by the Cancer Prevention and Treatment Institute of Texas [Grant RP160674] and the National Institutes of Health [Grants K05 CA134923, P30 AG024832, and UL1TR001439].
Publisher Copyright:
© 2019 American College of Chest Physicians
PY - 2020/2
Y1 - 2020/2
N2 - Background: Clinical trials have demonstrated a mortality benefit from lung cancer screening by low-dose CT (LDCT) in current or past tobacco smokers who meet criteria. Potential harms of screening mostly relate to downstream evaluation of abnormal screens. Few data exist on the rates outside of clinical trials of imaging and diagnostic procedures following screening LDCT. We describe rates in the community setting of follow-up imaging and diagnostic procedures after screening LDCT. Methods: We used Clinformatics Data Mart national database to identify enrollees age 55 to 80 year who underwent screening LDCT from January 1, 2016, to December 31, 2016. We assessed rates of follow-up imaging (diagnostic chest CT scan, MRI, and PET) and follow-up procedures (bronchoscopy, percutaneous biopsy, thoracotomy, mediastinoscopy, and thoracoscopy) in the 12 months following LDCT for lung cancer screening. We also assessed these rates in an age-, sex-, and number of comorbidities-matched population that did not undergo LDCT to estimate rates unrelated to the screening LDCT. We then reported the adjusted rate of follow-up testing as the observed rate in the screening LDCT population minus the rate in the non-LDCT population. Results: Among 11,520 enrollees aged 55 to 80 years who underwent LDCT in 2016, the adjusted rates of follow up 12 months after LDCT examinations were low (17.7% for imaging and 3.1% for procedures). Among procedures, the adjusted rates were 2.0% for bronchoscopy, 1.3% for percutaneous biopsy, 0.9% for thoracoscopy, 0.2% for mediastinoscopy, and 0.4% for thoracotomy. Adjusted rates of follow-up procedures were higher in enrollees undergoing an initial screening LDCT (3.3%) than in those after a second screening examination (2.2%). Conclusions: In general, imaging and rates of procedures after screening LDCT was low in this commercially insured population.
AB - Background: Clinical trials have demonstrated a mortality benefit from lung cancer screening by low-dose CT (LDCT) in current or past tobacco smokers who meet criteria. Potential harms of screening mostly relate to downstream evaluation of abnormal screens. Few data exist on the rates outside of clinical trials of imaging and diagnostic procedures following screening LDCT. We describe rates in the community setting of follow-up imaging and diagnostic procedures after screening LDCT. Methods: We used Clinformatics Data Mart national database to identify enrollees age 55 to 80 year who underwent screening LDCT from January 1, 2016, to December 31, 2016. We assessed rates of follow-up imaging (diagnostic chest CT scan, MRI, and PET) and follow-up procedures (bronchoscopy, percutaneous biopsy, thoracotomy, mediastinoscopy, and thoracoscopy) in the 12 months following LDCT for lung cancer screening. We also assessed these rates in an age-, sex-, and number of comorbidities-matched population that did not undergo LDCT to estimate rates unrelated to the screening LDCT. We then reported the adjusted rate of follow-up testing as the observed rate in the screening LDCT population minus the rate in the non-LDCT population. Results: Among 11,520 enrollees aged 55 to 80 years who underwent LDCT in 2016, the adjusted rates of follow up 12 months after LDCT examinations were low (17.7% for imaging and 3.1% for procedures). Among procedures, the adjusted rates were 2.0% for bronchoscopy, 1.3% for percutaneous biopsy, 0.9% for thoracoscopy, 0.2% for mediastinoscopy, and 0.4% for thoracotomy. Adjusted rates of follow-up procedures were higher in enrollees undergoing an initial screening LDCT (3.3%) than in those after a second screening examination (2.2%). Conclusions: In general, imaging and rates of procedures after screening LDCT was low in this commercially insured population.
KW - LDCT
KW - NLST
KW - chest imaging
KW - computed tomography
KW - follow up
KW - health-care utilization
KW - imaging
KW - lung cancer screening
KW - procedures
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U2 - 10.1016/j.chest.2019.08.2187
DO - 10.1016/j.chest.2019.08.2187
M3 - Article
C2 - 31521671
AN - SCOPUS:85075503450
SN - 0012-3692
VL - 157
SP - 427
EP - 434
JO - Diseases of the chest
JF - Diseases of the chest
IS - 2
ER -