Core Concepts
Lung cancer screening was associated with earlier-stage diagnoses and improved overall and lung cancer-specific survival rates among Veteran Health Administration patients.
Abstract
This retrospective study examined the impact of lung cancer screening on diagnosis and survival outcomes among Veteran Health Administration patients diagnosed with lung cancer between 2011 and 2018.
Key findings:
- 3.9% of the 57,919 lung cancer patients had undergone screening with at least one low-dose CT scan prior to their diagnosis.
- Screened patients had double the rate of stage I diagnoses (52% vs 27%) and about one-third the rate of stage IV diagnoses (11% vs 32%) compared to unscreened patients.
- Screened patients had significantly better overall survival rates at 1 year (81.2% vs 56.6%), 2 years (69.9% vs 41.1%), and 5 years (44.9% vs 22.3%).
- Lung cancer-specific survival rates were also higher in the screened group at 1 year (82.5% vs 58.7%), 2 years (74.3% vs 44.4%), and 5 years (59.0% vs 29.7%).
- Among screening-eligible patients who received guideline-concordant treatment, screening was associated with substantial reductions in all-cause mortality (adjusted HR 0.79) and lung cancer-specific mortality (adjusted HR 0.61).
- The authors conclude that these findings provide real-world evidence supporting the benefits of lung cancer screening observed in randomized trials, and hope it will spur greater uptake of this life-saving intervention.
Stats
3.9% of 57,919 lung cancer patients had prior lung cancer screening.
Screened patients had a 52% rate of stage I diagnosis vs 27% in unscreened patients.
Screened patients had an 11% rate of stage IV diagnosis vs 32% in unscreened patients.
1-year overall survival was 81.2% in screened vs 56.6% in unscreened patients.
2-year overall survival was 69.9% in screened vs 41.1% in unscreened patients.
5-year overall survival was 44.9% in screened vs 22.3% in unscreened patients.
1-year lung cancer-specific survival was 82.5% in screened vs 58.7% in unscreened patients.
2-year lung cancer-specific survival was 74.3% in screened vs 44.4% in unscreened patients.
5-year lung cancer-specific survival was 59.0% in screened vs 29.7% in unscreened patients.
Quotes
"These findings provide corroboration of the results of randomized [lung cancer screening] trials in clinical practice."
"We hope that the striking association between [lung cancer screening], earlier stage diagnosis of lung cancer, and improved mortality spurs a more robust uptake of this life-saving intervention into clinical practice."