CHEST 2018: Update on Adherence to Lung Cancer Screening
Posted: Thursday, October 18, 2018
A study presented at the 2018 CHEST Annual Meeting in San Antonio found that adherence to annual low-dose computed tomography (LDCT) was inadequate within the Veteran Health Administration Lung Cancer Screening Demonstration Project. The study results indicate a need to implement measures to improve adherence rates and ensure adequate lung cancer screening among those with normal baseline scans.
“Our study demonstrates that even within the context of a well-designed, implemented, and guideline-adherent LDCT screening program, adherence is not optimal and does not reach the reported 95% of the National Lung Screening Trial when the baseline scan is negative,” concluded Paul Brasher, MD, and colleagues, of the Thoracic Oncology Research Group at the Medical University of South Carolina. “Both mortality and cost-efficacy are likely to suffer without better adherence.”
The study retrospectively analyzed 2,106 veterans across 8 Veterans Affairs hospitals who underwent a baseline LDCT scan. The authors defined adherence to screening the same as the National Lung Screening Trial did, as having undergone a follow-up LDCT within 15 months after a baseline scan. Screening was conducted in both current and former smokers (quite within the past 15 years); they were between the ages of 55 and 80 and had at least a 30-pack year smoking history.
Across all sites, repeating annual LDCT scans was recommended for 60% (n = 1,269) of participants who showed negative scans for nodules at least 4 mm. Of them, 1,120 individuals remained eligible, and 880 underwent follow-up scans, yielding an adherence rate of 77.6%.
