Evaluating lung cancer screening using low dose computed tomography (LDCT) scan in a community hospital: A retrospective study.

Abstract

e23060 Background: Lung cancer is the leading cause of cancer-related deaths worldwide. The National Lung Screening Trial (NLST) showed that screening for lung cancer with low-dose CT (LDCT) can detect the disease early and reduce mortality rates. It is crucial to optimize LDCT lung cancer screening in high-risk populations in primary care settings to prevent the disease. Despite the United States Preventive Services Task Force (USPSTF) recommendations, LDCT screening rates are low. The 2023 "State of Lung Cancer" report revealed that only 4.5% of high-risk individuals were screened nationally, a decline from 5.8% in 2022. However, Ohio's screening rate of 6.9% was significantly higher than the national average. This study aimed to determine the rate of LDCT screening among tissue-confirmed lung cancers. Methods: The study involved a retrospective analysis of tissue-confirmed non-small cell lung cancer (NSCLC) cases (n = 116) in the tumor registry. The electronic medical records (EMR) of lung cancer patients were reviewed for documentation of LDCT and other registry data, including demographics, histology, clinical and pathological stage, recurrence, and vital status. Results: The accessioned lung cancer patients with NSCLC (adenocarcinoma) had an average age of 67.5 + 10 years, and 60.3% were male, with 9.5% being non-white. The study found that only 24.1% (28/116) of patients with lung cancer had undergone LDCT screening. The mortality rate in the series was 27.61% (32/116). AJCC clinical and pathological stage was associated with mortality (p < 0.05). Among survivors, 7.1% of presentations were pathologically AJCC staged 3 or 4, while among non-survivors, 25.1% of presentations were stage 3 or 4. No difference by stage and LDLCT was noted. The study found that screened patients were younger, with an average age of 64, compared to 69 years for non-screened patients (t = 1.983, p = 0.05). No sex or race differences by screening were observed. Conclusions: During the local enrollment in NLST for NCI, the tumor registry showed a higher proportion of early cancers (stage 1), indicating downstaging. However, no difference in stage by screening was found in the current study. Compared to screening rates for breast, prostate, or colorectal cancer, lung cancer screening rates are low despite the high case lethality of lung cancer. Screening for lung cancer in community hospital settings can improve early detection and patient outcomes. Implementing targeted education campaigns, expanding access to screening services, and optimizing communication between healthcare providers and patients is essential to increasing LDLCT screening rates.