BTOG: Poster Presentation
Lucinda Palmer, Jodie Chalmers, Ben Probyn, Sarah Foster, Vidan Masani, Anthony Edey, Anna Bibby
Abstract
Introduction
Lung cancer screening saves lives but has recognised limitations. Potential harms include over-investigation, missed diagnoses and cancers developing between screening rounds. We investigated clinical outcomes from the SWAG TLHC programme.
Methods
Clinical records, CT results and Screening Review Meeting outcomes were reviewed for all participants who underwent baseline TLHC scans between 11/08/2022–10/08/2023. Secondary care cancer registers and multidisciplinary team meetings were cross-referenced by NHS number to identify subsequent cancer diagnoses (censored 30/10/2024). Outcomes were categorised as true positive, true negative, false positive or false negative, with sub-categories based on clinical pathways (Figure 1).
Results
4200 people had baseline CT scans. Two people were excluded after moving out of area. 4098/4198 (97.6%) had negative scans and no subsequent lung cancer diagnoses (true negative). 80/4198 (1.9%) had abnormal TLHC scans and were subsequently diagnosed with lung cancer (true positive). Of these, 52/80 (65%) were referred at baseline, whilst 28/80 (35%) were referred after interval growth on nodule surveillance. 62/80 cancers (77.5%) were stage I-II and 66/80 (82.5%) were treated radically, usually with surgery (58/80; 72.5%). TLHC identified six extra pulmonary cancers (0.14%). Fifty people (1.2%) underwent investigations after abnormal scans but were not diagnosed with lung cancer. Of these, 4/4198 (0.09%) underwent surgery for benign pathology. One person was diagnosed with lung cancer 18 months after a reportedly normal TLC scan. On review of the original scan, a tumor was present, giving a false negative rate of 0.02%. Three people (0.07%) were diagnosed with lung cancer outside the programme. Review of THC scans revealed no detectable abnormalities, hence these were deemed interval incident cancers.
Conclusions
SWAG TLHC effectively identified early-stage lung cancers, resulting in high radical treatment rates. False positive rates were low, with surgery for non-malignant disease rare. TLHC identified several extra-pulmonary cancers, but a single lung cancer case was missed.
Disclaimers:
Chest Suite comprises multiple applications including Veye Lung Nodules, Veye Reporting, DeepHealth Chest CT AI, DeepHealth Viewer, DeepHealth Reporting, DeepHealth Worklist and HealthCCSng. Veye Lung Nodules and Veye Reporting are manufactured by Aidence B.V. and distributed by DeepHealth Inc. DeepHealth Viewer is manufactured by eRAD, Inc. and distributed by DeepHealth, Inc, HealthCCSng is manufactured by Nanox AI Ltd. and distributed by DeepHealth, Inc, DeepHealth Chest CT AI is 510(k) pending.
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