Feasibility of Lung Cancer Screening With Low-Dose Computed Tomography in a Rural Community Setting; An 8-Year Experience
Jacques Townsend2, Alyssa Toia2, Eric Korenman1, Christian Galvez1
1Berkshire Medical Center, Pittsfield, MA; 2University of Massachusetts, Worcester, MA
Background: Low-dose computed tomography (LDCT) screening guidelines per the United States Preventive Services Task Force (USPSTF) represent the most effective method to detect lung cancer at an early stage. Despite this, adoption of this practice has been mostly urban-centered and established protocols for screening in rural communities remains limited. To date, there is no published literature suggesting feasibility of an effective LDCT screening program at the rural level.
Methods: We performed a retrospective analysis of prospectively collected data from a single institution registry. Data was collected from 2013-2021. Referral patterns for LDCT screening follow the USPSTF guidelines. Results of imaging was in concordance with Lung-RADS guidelines. Patient entries were deidentified and included patient demographics, additional imaging, and diagnostic or therapeutic interventions that had occurred.
Results: Data from 2013 to 2021 found a total of 7807 screening studies were completed in the LDCT program. 117 (1.55%) patients obtained an invasive diagnostic/therapeutic procedure following abnormal results on screening LDCT. Nondiagnostic intervention rate was 0.4% of all screened patients and 29.9% of patients who had a positive screening test. A total of 114 (1.4%) lung cancers were detected and stratified into early (65%) vs late disease (35%).
Conclusion: LDCT screening programs are feasible in the rural community setting. Our data suggests similar outcomes in terms of lung cancer discovery rate (1.4%) when compared to large urban multicenter trials. We found that the majority of patients with a lung cancer diagnosis obtained from CT screening were at a lower stage at time diagnosis. Our data suggests the effectiveness of the LDCT screening protocols, and our institution specific creation suggests feasibility.
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