Abstract 155P
Background
Implementation of lung cancer screening with annual low-dose computed tomography (CT) scans has resulted in significant improvement in disease-specific and overall survival in large prospective studies. Little is known about the proportion of patients with lung cancer that would be eligible for participation in screening programs in the real world.
Methods
We performed a retrospective chart review of patients with lung cancer diagnosed at Sotiria General Hospital for Chest Diseases, Athens, Greece, between January 2016 and December 2018. Descriptive statistics were utilized to calculate the proportion of patients that would be eligible for lung cancer screening and chi-squared test to assess for associations between baseline patient characteristics and lung cancer screening criteria. All hypothesis testing was conducted at a two-sided significance level of α = 0.05.
Results
898 patients were screened; 750 patients were eligible for study inclusion. The median age at diagnosis was 67 years (range 34–93). Among study participants, 73.2%, 21.5%, and 5.3% were current, former, and never smokers, respectively. Histotypes were distributed as follows: adenocarcinoma, 42.7%; squamous cell carcinoma, 30.8%; small cell lung cancer, 14.7%; large cell neuroendocrine carcinoma, 3.6%; not otherwise specified, 4.1%; other, 4.0%%. Targetable driver alterations were identified in 16.9% of patients (39/231). The proportion of patients eligible for lung cancer screening at the time of diagnosis ranged according to screening criteria applied (NLST: 60.3%, USPSTF: 78.7%, NELSON: 64.4%). Baseline characteristics associated with qualification for screening according to the NLST criteria were squamous (OR, 2.23; 95% CI, 1.57–3.19; p < 0.00001) and small cell (OR, 2.10; 95% CI, 1.34–3.34; p = 0.001) histology and lack of targetable driver alterations (OR, 3.39; 95% CI, 1.49–8.54; p = 0.003).
Conclusions
Most patients with lung cancer qualify for screening at the time of diagnosis; baseline characteristics directly linked with smoking appear significantly associated with screening eligibility. This underlines the need for more personalized screening approaches in the absence of substantial smoking history.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.