Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
POSTER SESSION 1 - P1.03: RADIOLOGY/STAGING/SCREENING
SCREENING –
MONDAY, DECEMBER 5, 2016
P1.03-055 LUCAS DA: A LUNG CANCER SCREENING DECISION AID
TO IMPROVE SCREENING DECISIONS
Jamie Studts 1 , Kory Brinker 1 , Stacey Tannenbaum 2 , Margaret Byrne 2
1 University of Kentucky, Lexington/KY/United States of America, 2 Public Health
Sciences, University of Miami, Miami/FL/United States of America
Background: Although lung cancer (LC) continues to be one of the leading
causes of cancer morbidity and mortality world-wide, the NLST trial showed
that low dose computed tomography (LDCT) screening can substantially
reduce mortality in specific high-risk populations. However, most individuals
are not making informed decisions which take into account the risks of
screening although US guidelines advocate for informed decision-making. We
report preliminary results of a web-based interactive LC decision aid (LuCaS
DA) on LC screening knowledge and decision making compared to the US
National Cancer Institutes’ web-pages on LC screening. Methods: Individuals
in the study (n=50; from rural Kentucky and SE Florida, USA) had an elevated
risk for lung cancer (n=50) due to smoking. Participants completed a baseline
survey and were randomized to viewing the LuCaS DA or the NCI website.
After 2 weeks, participants completed an online survey. Surveys collected
information on: demographics, health status, smoking history, knowledge of
CT screening, decisions about being screened for lung cancer, and decisional
conflict about screening. Results: Participants were 52.6 (SD 5.1) years old
on average; were majority female (77.1%), White (62.0%), and non-Hispanic
(83.7%), and reported have some insurance coverage (88.0%). Most were
current daily smokers (70.2%), and overall had smoked an average of 27.9
(SD 7.7) years. Mean Decisional Conflict overall participants was 39.3 (SD
13.5) at baseline and 34.4 (SD 11.1) at 2 week follow up, with no differences
between the arms. The percentage of participants show stated that they had
made a decision about screening increased slightly from 32.7% at baseline
to 37.5% at follow up. Preparedness for making a decision about screening
(measured POST only) showed no differences between the arms. There were
some increases in knowledge about CT screening and knowledge about LCS
guidelines from initial to 2-week follow up. Finally, a qualitative exploration
of the LuCaS DA showed that it had high levels of acceptability. Conclusion:
DAs can facilitate informed decisions about participation in cancer screening,
and US policies have required their use. This is the first study that we are
aware of that assesses the use and effects of a lung cancer screening decision
aid. These preliminary results show that the LuCaS DA can improve some
outcomes, but not consistently more than the NCI webpages. Additional
analyses will include the full sample of participants, evaluate a broader array
of decision and behavioral outcomes, and consider longer term outcomes of
the LuCaS DA.
Keywords: decision aids, Lung cancer creening, decision-making
POSTER SESSION 1 - P1.03: RADIOLOGY/STAGING/SCREENING
SCREENING –
MONDAY, DECEMBER 5, 2016
P1.03-056 IMPLEMENTATION OF A PROSPECTIVE BIOSPECIMEN
COLLECTION STUDY IN AN ESTABLISHED LUNG CANCER
SCREENING PROGRAM
Jacob Sands 1 , Katrina Steiling 2 , Travis Sullivan 3 , Sebastian Flacke 3 , Kimberly
Rieger-Christ 3
1 Oncology, Lahey Hospital & Medical Center, Burlington/MA/United States of
America, 2 Boston Medical Center, Boston/United States of America, 3 Lahey
Hospital & Medical Center, Burlington/MA/United States of America
Background: Complexities such as addressing indeterminate pulmonary
nodules (IPNs) are an inherent part of a lung screening program, and defining
which individuals will benefit from invasive intervention is not always
known. With the goal of combining non-invasive biomarkers with imaging
to more definitively stratify patients, we initiated an investigational
biospecimen collection process into our lung screening program. Ultimately,
these biomarkers may improve specificity within the screening population,
thereby reducing the overall cost and potential morbidity from false positive
results of low-dose computed tomography scan (LDCT) screening. Studies
like this are important to the ongoing improvement of lung cancer screening.
Methods: NCCN high-risk individuals enrolled in a high volume clinical lung
screening program were introduced to our IRB approved research biospecimen
study at the time of the scheduling of their LDCT. Patients were consented,
and routine biospecimens were collected by research staff at the time of
their LDCT scan, including nasal epithelial brushings, buccal swabs and
blood. When available, additional biospecimens consisting of bronchial
airway brushings and tumor samples were collected from subjects who
underwent diagnostic interventions for suspicion of malignancy. Results:
Since 2012 there have been 3856 patients enrolled and 8776 LDCT scans
to date with 100 lung cancer diagnoses within our lung screening program.
In 2014, funding (LUNGevity and Robert E Wise grants) was obtained for
biospecimen collection from subjects enrolled in our institutional LDCT
screening program. Initial prospective collection of biospecimens was slower
than anticipated due to various factors. After review of the process, a number
of adjustments were made, which significantly increased enrollment. This
included implementation of a multidisciplinary taskforce consisting of
research and clinical staff committed to patient outreach and participation.
To date, samples from approximately 1420 subjects have been collected.
Of these, 268 (19%) were found to have newly detected IPNs measuring
6-20mm on LDCT, and 28 samples were from patients with subsequent
diagnoses of lung cancer. Conclusion: Successful coordination of biospecimen
collection within a lung screening program is complex, but achievable with
multidisciplinary coordination, and has great potential to help further
stratify patients that may or may not benefit from invasive diagnostics and
therapy. We demonstrate an established lung screening program that is
successfully accruing to a prospective diagnostic study and share specific
recommendations for how to successfully accrue in other programs.
Keywords: biospecimen, blood sample, Lung Screening, Indeterminate
pulmonary nodule
POSTER SESSION 1 - P1.03: RADIOLOGY/STAGING/SCREENING
SCREENING –
MONDAY, DECEMBER 5, 2016
P1.03-057 ASSESSMENT OF LUNG CANCER RISK- REGIONAL
RESPIRATORY DISEASE SCREENING REPORT IN JILIN, CHINA
Jie Zhang, Yan Xu, Peng Gao, Guang Meng, Qi Wang, Jun Li, Xue Lv, Yu Hao,
Hong Zhou
Respiratory Medicine, Second Affiliated Hospital of Jilin University, Changchun/
China
Background: Both morbidity and mortality of lung cancer ranks first in China.
According to the “2012 cancer registration report of China”, Northeast China
is a high prevalence area of lung cancer, so early diagnosis of lung cancer
is particularly important. Based on this, we made the regional survey in
Changchun city. (1) To investigate the incidence of pulmonary nodules and
lung cancer in Changchun city. (2)To provide the foundation of large data
study on early screening of lung cancer and disease control. Methods: Carry
out the investigation of the people over 50 years of age in 10 communities in
Changchun of Jilin Province (A total of 1461 people), including questionnaire,
pulmonary function tests and low-dose spiral CT examination. The disease
assessment and patient management are based on “Diagnosis and treatment
of pulmonary nodules in Chinese expert consensus”. Results: The percentage
of lung disease in the investigated population was 25.67%, and the
constitution of the lung disease included: 30.67% of the lung nodules, 37.07%
of chronic obstructive pulmonary disease, 18.67% of inflammation, 5.6% of
the lung, 2.13% of pulmonary interstitial fibrosis, 2.13% of pleural effusion
and 3.73% of other lung diseases. The number of pulmonary nodules was 115,
accounting for 7.87% of the total number of screening, 89 cases of solitary
nodules, 26 cases of multiple nodules. A total of 4 patients with lung cancer
were confirmed by pathology, including 2 cases of adenocarcinoma, 1 cases of
squamous cell carcinoma and 1 case of mucinous carcinoma of the lung. All of
the cancer cases were solitary nodules, and accounted for 3.48% of the total
samples. Among them, 3 patients are male with a history of smoking, and 1
is female without any history of smoking. According to the nodule size, the
diameters of nodule in 3 cases are greater than 8mm and 1 case is less than
4mm. According to the quality of nodules, 3 cases are solid and mixed nodules,
and 1 case is ground-glass opacity. Conclusion: (1)Smoking is a risk factor for
lung cancer. (2) Solid and mixed character nodules in pulmonary nodules and
larger diameter nodules are more likely to develop into cancer, so they should
be strengthened management. (3) Low-dose spiral CT is helpful for early
diagnosis of lung cancer.
Keywords: Low-dose spiral CT, lung cancer, pulmonary nodules
POSTER SESSION 1 - P1.03: RADIOLOGY/STAGING/SCREENING
SCREENING –
MONDAY, DECEMBER 5, 2016
P1.03-058 COST-EFFECTIVENESS OF CT SCREENING IN THE EARLY
DETECTION OF LUNG CANCER
Tomasz Szczęsny 1 , Małgorzata Kanarkiewicz 2 , Janusz Kowalewski 3
1 Department of Thoracic Surgery and Tumors, Franciszek Lukaszczyk Memorial
Oncological Center in Bydgoszcz, Bydgoszcz/Poland, 2 Department of
Pharmacology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Torun, Bydgoszcz/Poland, 3 Department of Thoracic Surgery and Tumors, Collegium
Copyright © 2016 by the International Association for the Study of Lung Cancer
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