Norton Neuroscience Institute, Norton Healthcare, Louisville, KY.
Norton Cancer Institute, Norton Healthcare, Louisville, KY.
Fam Pract. 2020 Feb 19;37(1):25-29. doi: 10.1093/fampra/cmz036.
Lung cancer is the primary cause of cancer death in men and women in the USA, led by Kentucky. In 2015, the Centers for Medicare and Medicaid Services initiated annual lung cancer screening with a low-dose computed tomography (LDCT) scan. This observational cohort study evaluated the multidisciplinary approach to this screening in our metropolitan community.
We present the prospective findings of patients who underwent a screening lung LDCT scan over a 2-year period at our institution in Kentucky. Patients who fulfilled the screening criteria were identified during an office visit with their primary care provider.
Of the 4170 patients who underwent a screening lung LDCT scan, a total of 838 (20.9%) patients had nodules >4 mm. Of the 70 patients diagnosed with lung cancer, Stage 1 non-small cell lung cancer was most commonly detected [38 cases (54.3%)]. A follow-up lung LDCT scan (n = 897), pulmonary function test (n = 157), positron emission tomography scan (n = 12) and a lung biopsy (n = 53) were performed for certain individuals who had anomalies observed on the screening lung LDCT scan. A total of 42% of patients enrolled in group tobacco cessation classes quit smoking.
This study provides a unique perspective of a lung LDCT scan screening program driven by primary care providers in a state plagued by cigarette smoking and lung cancer deaths and offers a valuable message into the prevention, high-risk screening and diagnosis of lung cancer.
肺癌是美国男性和女性癌症死亡的主要原因,肯塔基州首当其冲。2015 年,医疗保险和医疗补助服务中心启动了年度肺癌筛查计划,使用低剂量计算机断层扫描(LDCT)进行筛查。本观察性队列研究评估了我们大都市社区对这种筛查的多学科方法。
我们介绍了在肯塔基州我们的机构进行为期 2 年的筛查性 LDCT 扫描的患者的前瞻性发现。在初级保健提供者的就诊期间,符合筛查标准的患者被确定。
在 4170 名接受筛查性 LDCT 扫描的患者中,共有 838 名(20.9%)患者的结节>4 毫米。在诊断为肺癌的 70 名患者中,最常见的是Ⅰ期非小细胞肺癌[38 例(54.3%)]。对在筛查性 LDCT 扫描中观察到异常的某些人进行了后续的 LDCT 扫描(n=897)、肺功能测试(n=157)、正电子发射断层扫描(n=12)和肺活检(n=53)。在参加烟草戒烟课程的患者中,共有 42%的患者戒烟。
这项研究提供了一个独特的视角,展示了由初级保健提供者在一个深受吸烟和肺癌死亡困扰的州驱动的 LDCT 扫描筛查计划,并提供了一个关于肺癌预防、高危筛查和诊断的有价值的信息。