Exploring the impact of screening with low-dose CT on lung cancer mortality in mild to moderate COPD patients: A pilot study
Summary Background COPD is an independent risk factor for lung cancer, especially in patients with mild to moderate disease. Objective To determine if performing lung cancer screening in GOLD 1 and 2 COPD patients, results in reduced lung cancer mortality. Methods This study compared patients with m...
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| Veröffentlicht in: | Respiratory medicine 2013-05, Vol.107 (5), p.702-707 |
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| creator | de-Torres, Juan P Casanova, Ciro Marín, Jose M Zagaceta, Jorge Alcaide, Ana B Seijo, Luis M Campo, Arantza Carrizo, Santiago Montes, Usua Cordoba-Lanus, Elizabeth Baz-Dávila, Rebeca Aguirre-Jaime, Armando Celli, Bartolome R Zulueta, Javier J |
| description | Summary Background COPD is an independent risk factor for lung cancer, especially in patients with mild to moderate disease. Objective To determine if performing lung cancer screening in GOLD 1 and 2 COPD patients, results in reduced lung cancer mortality. Methods This study compared patients with mild to moderate COPD from 2 cohorts matched for age, gender, BMI, FEV1 %, pack-yrs history and smoking status. The screening group (SG) had an annual low dose computed tomography (LDCT). The control group (CG) was prospectively followed with usual care. Lung cancer incidence and mortality densities were compared between groups. Results From an initial sample of 410 (SG) and 735 (CG) patients we were able to match 333 patients from each group. At the same follow-up time lung cancer incidence density was 1.79/100 person-years in the SG and 4.14/100 person-years in the CG ( p = 0.004). The most frequent histological type was adenocarcinoma in both SG and CG (65% and 46%, respectively), followed by squamous cell carcinoma (25% and 37%, respectively). Eighty percent of lung cancers in the SG (16/20) were diagnosed in stage I, and all of CG cancers (35/35) were in stage III or IV. Mortality incidence density from lung cancer (0.08 vs. 2.48/100 person-years, p |
| doi_str_mv | 10.1016/j.rmed.2013.01.013 |
| format | Article |
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Objective To determine if performing lung cancer screening in GOLD 1 and 2 COPD patients, results in reduced lung cancer mortality. Methods This study compared patients with mild to moderate COPD from 2 cohorts matched for age, gender, BMI, FEV1 %, pack-yrs history and smoking status. The screening group (SG) had an annual low dose computed tomography (LDCT). The control group (CG) was prospectively followed with usual care. Lung cancer incidence and mortality densities were compared between groups. Results From an initial sample of 410 (SG) and 735 (CG) patients we were able to match 333 patients from each group. At the same follow-up time lung cancer incidence density was 1.79/100 person-years in the SG and 4.14/100 person-years in the CG ( p = 0.004). The most frequent histological type was adenocarcinoma in both SG and CG (65% and 46%, respectively), followed by squamous cell carcinoma (25% and 37%, respectively). Eighty percent of lung cancers in the SG (16/20) were diagnosed in stage I, and all of CG cancers (35/35) were in stage III or IV. Mortality incidence density from lung cancer (0.08 vs. 2.48/100 person-years, p < 0.001) was lower in the SG. Conclusions This pilot study in patients with mild to moderate COPD suggests that screening with LDCT detects lung cancer in early stages, and could decrease lung cancer mortality in that high risk group. Appropriately designed studies should confirm these important findings.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2013.01.013</identifier><identifier>PMID: 23465176</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Age ; Aged ; Body mass index ; Chronic obstructive pulmonary disease ; Classification ; COPD ; Design ; Early Detection of Cancer - methods ; Female ; Forced Expiratory Volume - physiology ; Gender ; Hospitals ; Humans ; Kaplan-Meier Estimate ; Lung cancer ; Lung Neoplasms - diagnostic imaging ; Lung Neoplasms - etiology ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Male ; Middle Aged ; Mortality ; Neoplasm Staging ; Normal distribution ; Patient Selection ; Patients ; Pilot Projects ; Pulmonary Disease, Chronic Obstructive - complications ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary/Respiratory ; Radiation Dosage ; Smoking ; Spain - epidemiology ; Tomography ; Tomography, X-Ray Computed - methods ; Vital Capacity - physiology</subject><ispartof>Respiratory medicine, 2013-05, Vol.107 (5), p.702-707</ispartof><rights>Elsevier Ltd</rights><rights>2013 Elsevier Ltd</rights><rights>Copyright © 2013 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited May 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-accbbe40dbef6e579ba35a8fb38b1ac549a10a9a1eba2d26736782d7cce70cd13</citedby><cites>FETCH-LOGICAL-c483t-accbbe40dbef6e579ba35a8fb38b1ac549a10a9a1eba2d26736782d7cce70cd13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0954611113000395$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23465176$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de-Torres, Juan P</creatorcontrib><creatorcontrib>Casanova, Ciro</creatorcontrib><creatorcontrib>Marín, Jose M</creatorcontrib><creatorcontrib>Zagaceta, Jorge</creatorcontrib><creatorcontrib>Alcaide, Ana B</creatorcontrib><creatorcontrib>Seijo, Luis M</creatorcontrib><creatorcontrib>Campo, Arantza</creatorcontrib><creatorcontrib>Carrizo, Santiago</creatorcontrib><creatorcontrib>Montes, Usua</creatorcontrib><creatorcontrib>Cordoba-Lanus, Elizabeth</creatorcontrib><creatorcontrib>Baz-Dávila, Rebeca</creatorcontrib><creatorcontrib>Aguirre-Jaime, Armando</creatorcontrib><creatorcontrib>Celli, Bartolome R</creatorcontrib><creatorcontrib>Zulueta, Javier J</creatorcontrib><title>Exploring the impact of screening with low-dose CT on lung cancer mortality in mild to moderate COPD patients: A pilot study</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Summary Background COPD is an independent risk factor for lung cancer, especially in patients with mild to moderate disease. Objective To determine if performing lung cancer screening in GOLD 1 and 2 COPD patients, results in reduced lung cancer mortality. Methods This study compared patients with mild to moderate COPD from 2 cohorts matched for age, gender, BMI, FEV1 %, pack-yrs history and smoking status. The screening group (SG) had an annual low dose computed tomography (LDCT). The control group (CG) was prospectively followed with usual care. Lung cancer incidence and mortality densities were compared between groups. Results From an initial sample of 410 (SG) and 735 (CG) patients we were able to match 333 patients from each group. At the same follow-up time lung cancer incidence density was 1.79/100 person-years in the SG and 4.14/100 person-years in the CG ( p = 0.004). The most frequent histological type was adenocarcinoma in both SG and CG (65% and 46%, respectively), followed by squamous cell carcinoma (25% and 37%, respectively). Eighty percent of lung cancers in the SG (16/20) were diagnosed in stage I, and all of CG cancers (35/35) were in stage III or IV. Mortality incidence density from lung cancer (0.08 vs. 2.48/100 person-years, p < 0.001) was lower in the SG. Conclusions This pilot study in patients with mild to moderate COPD suggests that screening with LDCT detects lung cancer in early stages, and could decrease lung cancer mortality in that high risk group. Appropriately designed studies should confirm these important findings.</description><subject>Age</subject><subject>Aged</subject><subject>Body mass index</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Classification</subject><subject>COPD</subject><subject>Design</subject><subject>Early Detection of Cancer - methods</subject><subject>Female</subject><subject>Forced Expiratory Volume - physiology</subject><subject>Gender</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - diagnostic imaging</subject><subject>Lung Neoplasms - etiology</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoplasm Staging</subject><subject>Normal distribution</subject><subject>Patient Selection</subject><subject>Patients</subject><subject>Pilot Projects</subject><subject>Pulmonary Disease, Chronic Obstructive - complications</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Pulmonary/Respiratory</subject><subject>Radiation Dosage</subject><subject>Smoking</subject><subject>Spain - epidemiology</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Vital Capacity - physiology</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kt9rFDEQx4Mo9qz-Az5IwJe-7Jlfu3srIpSzaqFQwfocssmszZndrEm29cA_3oRrEfpQGBKY-cyXZL6D0GtK1pTQ5t1uHUYwa0YoXxOagz9BK1pzVnHSiKdoRbpaVA2l9Ai9iHFHCOmEIM_REeOiqWnbrNDfsz-z88FOP3G6BmzHWemE_YCjDgBTyd_adI2dv62Mj4C3V9hP2C25oNWkIeDRh6ScTXtsJzxaZ3DyOWkgqJT5y2-f8KyShSnF9_gUz9b5hGNazP4lejYoF-HV3X2Mfnw-u9p-rS4uv5xvTy8qLTY8VUrrvgdBTA9DA3Xb9YrXajP0fNNTpWvRKUpUPqBXzLCm5U27YabVGlqiDeXH6OSgOwf_e4GY5GijBufUBH6JknJWcy5IxzP69gG680uY8usKJVjL66bLFDtQOvgYAwxyDnZUYS8pkcUbuZPFG1m8kYTmKNJv7qSXvtTuW-7NyMCHAwB5FjcWgow6j02DsQF0ksbbx_U_PmjXzk5WK_cL9hD__0NGJon8XrajLAfleTF4V_N_00G1cQ</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>de-Torres, Juan P</creator><creator>Casanova, Ciro</creator><creator>Marín, Jose M</creator><creator>Zagaceta, Jorge</creator><creator>Alcaide, Ana B</creator><creator>Seijo, Luis M</creator><creator>Campo, Arantza</creator><creator>Carrizo, Santiago</creator><creator>Montes, Usua</creator><creator>Cordoba-Lanus, Elizabeth</creator><creator>Baz-Dávila, Rebeca</creator><creator>Aguirre-Jaime, Armando</creator><creator>Celli, Bartolome R</creator><creator>Zulueta, Javier J</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20130501</creationdate><title>Exploring the impact of screening with low-dose CT on lung cancer mortality in mild to moderate COPD patients: A pilot study</title><author>de-Torres, Juan P ; Casanova, Ciro ; Marín, Jose M ; Zagaceta, Jorge ; Alcaide, Ana B ; Seijo, Luis M ; Campo, Arantza ; Carrizo, Santiago ; Montes, Usua ; Cordoba-Lanus, Elizabeth ; Baz-Dávila, Rebeca ; Aguirre-Jaime, Armando ; Celli, Bartolome R ; Zulueta, Javier J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-accbbe40dbef6e579ba35a8fb38b1ac549a10a9a1eba2d26736782d7cce70cd13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>Aged</topic><topic>Body mass index</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Classification</topic><topic>COPD</topic><topic>Design</topic><topic>Early Detection of Cancer - methods</topic><topic>Female</topic><topic>Forced Expiratory Volume - physiology</topic><topic>Gender</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - diagnostic imaging</topic><topic>Lung Neoplasms - etiology</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neoplasm Staging</topic><topic>Normal distribution</topic><topic>Patient Selection</topic><topic>Patients</topic><topic>Pilot Projects</topic><topic>Pulmonary Disease, Chronic Obstructive - complications</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Pulmonary/Respiratory</topic><topic>Radiation Dosage</topic><topic>Smoking</topic><topic>Spain - epidemiology</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Vital Capacity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de-Torres, Juan P</creatorcontrib><creatorcontrib>Casanova, Ciro</creatorcontrib><creatorcontrib>Marín, Jose M</creatorcontrib><creatorcontrib>Zagaceta, Jorge</creatorcontrib><creatorcontrib>Alcaide, Ana B</creatorcontrib><creatorcontrib>Seijo, Luis M</creatorcontrib><creatorcontrib>Campo, Arantza</creatorcontrib><creatorcontrib>Carrizo, Santiago</creatorcontrib><creatorcontrib>Montes, Usua</creatorcontrib><creatorcontrib>Cordoba-Lanus, Elizabeth</creatorcontrib><creatorcontrib>Baz-Dávila, Rebeca</creatorcontrib><creatorcontrib>Aguirre-Jaime, Armando</creatorcontrib><creatorcontrib>Celli, Bartolome R</creatorcontrib><creatorcontrib>Zulueta, Javier J</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de-Torres, Juan P</au><au>Casanova, Ciro</au><au>Marín, Jose M</au><au>Zagaceta, Jorge</au><au>Alcaide, Ana B</au><au>Seijo, Luis M</au><au>Campo, Arantza</au><au>Carrizo, Santiago</au><au>Montes, Usua</au><au>Cordoba-Lanus, Elizabeth</au><au>Baz-Dávila, Rebeca</au><au>Aguirre-Jaime, Armando</au><au>Celli, Bartolome R</au><au>Zulueta, Javier J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exploring the impact of screening with low-dose CT on lung cancer mortality in mild to moderate COPD patients: A pilot study</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>107</volume><issue>5</issue><spage>702</spage><epage>707</epage><pages>702-707</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Summary Background COPD is an independent risk factor for lung cancer, especially in patients with mild to moderate disease. Objective To determine if performing lung cancer screening in GOLD 1 and 2 COPD patients, results in reduced lung cancer mortality. Methods This study compared patients with mild to moderate COPD from 2 cohorts matched for age, gender, BMI, FEV1 %, pack-yrs history and smoking status. The screening group (SG) had an annual low dose computed tomography (LDCT). The control group (CG) was prospectively followed with usual care. Lung cancer incidence and mortality densities were compared between groups. Results From an initial sample of 410 (SG) and 735 (CG) patients we were able to match 333 patients from each group. At the same follow-up time lung cancer incidence density was 1.79/100 person-years in the SG and 4.14/100 person-years in the CG ( p = 0.004). The most frequent histological type was adenocarcinoma in both SG and CG (65% and 46%, respectively), followed by squamous cell carcinoma (25% and 37%, respectively). Eighty percent of lung cancers in the SG (16/20) were diagnosed in stage I, and all of CG cancers (35/35) were in stage III or IV. Mortality incidence density from lung cancer (0.08 vs. 2.48/100 person-years, p < 0.001) was lower in the SG. Conclusions This pilot study in patients with mild to moderate COPD suggests that screening with LDCT detects lung cancer in early stages, and could decrease lung cancer mortality in that high risk group. Appropriately designed studies should confirm these important findings.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23465176</pmid><doi>10.1016/j.rmed.2013.01.013</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aged Body mass index Chronic obstructive pulmonary disease Classification COPD Design Early Detection of Cancer - methods Female Forced Expiratory Volume - physiology Gender Hospitals Humans Kaplan-Meier Estimate Lung cancer Lung Neoplasms - diagnostic imaging Lung Neoplasms - etiology Lung Neoplasms - mortality Lung Neoplasms - pathology Male Middle Aged Mortality Neoplasm Staging Normal distribution Patient Selection Patients Pilot Projects Pulmonary Disease, Chronic Obstructive - complications Pulmonary Disease, Chronic Obstructive - physiopathology Pulmonary/Respiratory Radiation Dosage Smoking Spain - epidemiology Tomography Tomography, X-Ray Computed - methods Vital Capacity - physiology |
| title | Exploring the impact of screening with low-dose CT on lung cancer mortality in mild to moderate COPD patients: A pilot study |
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