High-risk lung cancer screening programs may be inefficient, lead to delays

Adherence to follow-up recommendations after a positive low-dose computed tomography (LDCT) lung cancer screening (LCS) are inconsistent, even in established programs, according to a study.

“To achieve the LCS mortality benefit in clinical trials, timely, real-world follow-up of abnormal test results is necessary. Presently, annual LCS rates are lower than in trials, and adherence to follow-up after suspicious findings has not been well studied,” the authors wrote.

In this retrospective study, 106 patients with a positive LDCT scan between 2013 and 2020 who were recommended shorter intervals for repeat computed tomography (CT), CT biopsy, or positron emission tomography/CT were included. Adherence was considered completing prescribed imaging by 15 days after the recommended 7-, 30-, and 90-day follow-up and by 30 days after the 180-day recommended follow-up.

Follow-up recommendations were completed by 60% of patients. Adherence was 72% at 30 days follow-up, 63% at 90 days follow-up, and 42% at 180 days follow-up. Males were found to have lower adherence rates.

There were 23 patients diagnosed with new lung cancer after a positive LDCT scan, of which 82% of cancers were Stage 1A or limited stage. Among these patients, 83% were adherent to follow-up testing.

Reference
Kee D, Sigel KM, Wisnivesky JP, Kale MS. Timely adherence to follow-up after high-risk lung cancer screenings. J Med Screen. 2023;9691413231162507. doi: 10.1177/09691413231162507. Epub ahead of print. PMID: 36916158.