176MO - Low-dose computed tomography lung cancer screening participants live longer than matched controls: A population-based study

Background

The current evidence from randomized controlled trials confirmed mortality reduction caused by LDCT lung cancer screening. Data on the effect of screening on mortality in observational trials are limited. This study aims to assess the 10-year overall survival of the lung cancer LDCT screened group compared to a matched unscreened control group.

Methods

In this observational cohort study, the data of 43,686 patients from the database of the National Health Fund (NFZ) aged 50-75 were analyzed. The study group consisted of 7281 individuals who underwent LDCT lung cancer screening in Pilot Pomeranian Lung Cancer Screening Program performed between 2009-2011 and matched controls from a general Polish population. Data on comorbidities and survival of program participants and the general population were collected from the National Health Found registry covering medical services for almost all Polish citizens. The survival and comorbidities of 7281 participants of PPLCSPP and 36,405 matched controls were selected from the population of 9.81 million people from the NFZ registry. The control group was randomly selected from among 9.81 million people from the NFZ database using the 1:5 propensity score matching method using variables: age, sex, chronic and acute diseases, neoplasm, demographic indicators regarding the number of physicians per 10,000 inhabitants, and the average monthly salary in the place of residence. Patients were followed for at least 10 years for events requiring treatment and diseases, and for death.

Results

Multivariate analysis showed a beneficial effect on long-term survival of participation in the screening study HR=0.653. Factors negatively affecting survival are lung cancer diagnosis HR=5,141, stroke HR=2,451, colorectal cancer HR=2,166, heart failure HR=2,061, chronic kidney disease HR=2,044, breast cancer HR=1,837, COPD HR= 1,766, atherosclerosis HR=1,503, diabetes HR=1,471. The 10-year survival of the screening group was statistically more favorable and amounted to 86.9%, the control group 81.3%, p<0.001.

Conclusions

Participants of LDCT lung cancer screening have reduced all-cause mortality compared to the general population of people the age 50-75.

Legal entity responsible for the study

Narodowy Fundusz Zdrowia.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.