Positive lung cancer screening (LCS) exams are more frequent in a national screening population compared with participants in the National Lung Screening Trial (NLST), researchers have reported.
“[Our study found that] Lung-RADS scores in clinical LCS are higher than in the NLST, even after adjusting for known confounders such as age and smoking,” wrote a team led by Tina Tailor, MD, of Duke Health in Durham, NC.
Lung cancer screening with low-dose chest CT is recommended for high-risk populations in the U.S., but it’s unclear how cancer incidence identified in clinical screening compares with that identified in research trials. To address this knowledge gap, the group compared Lung-RADS scores between a nationally screened population from the American College of Radiology’s LCS Registry (LCSR) and the National Lung Screening Trial (NLST).
The study included data from 686,011 participants from the LCSR and 26,432 from the NLST. The LCSR population was older, with a mean age of 64 compared with a mean age of 61.4 in the NLST cohort, and more likely than NLST participants to be currently smoking (61.5% vs. 48.1%).
The investigators found that, after adjusting for age, gender, smoking history, and body mass index, the LCSR group was more likely to have higher Lung-RADS scores than the NLST cohort, indicating more severity of disease.
“[Our findings] imply higher rates of follow-up testing after LCS and potentially higher cancer rates in the clinically screened population than the NLST,” they concluded.
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