Baseline Results of the West London lung cancer screening pilot study - Impact of mobile scanners and dual risk model utilisation
Baseline Results of the West London lung cancer screening pilot study - Impact of mobile scanners and dual risk model utilisation
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DOI：
10.1016/j.lungcan.2020.07.027
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发表时间：
2020-10-01
期刊：
影响因子：
5.3
通讯作者：
Vaughan-Smith, Stephen
中科院分区：
文献类型：
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作者：
Bartlett, Emily C.;Kemp, Samuel, V;Vaughan-Smith, Stephen
目标：西伦敦肺部筛查试点旨在通过针对高风险参与者进行低剂量 CT (LDCT) 来识别早期肺癌。成功实施筛查需要最大限度地提高参与者的参与度并识别风险最高的人。除了报告预先指定的基线筛查指标外，其他目标还包括 1) 比较参与者对移动 CT 扫描仪和医院 CT 扫描仪的使用率，以及 2) 使用两种肺癌风险模型评估对癌症检测的影响。 方法：根据初级保健记录，邀请 60-75 岁的曾经吸烟者在医院或移动站点进行肺部健康检查。 PLCOM2012 6 年风险 >= 1.51 % 和/或 LLPv2 5 年风险 >= 2.0 % 的参与者接受了 LDCT。报告肺癌检出率、分期和召回率。比较两个地点的参与者吸收情况（卡方检验）。比较了每种风险模型下招募的受试者之间的 LDCT 资格和癌症检出率。结果：在受邀的 8366 名潜在参与者中，1047/5135 (20.4%) 名受邀者响应了医院网站的邀请，702/3231 (21.7%) 名受邀者响应了移动网站的邀请 (p = 0.14)。前往医院地点的中位距离小于前往移动地点的中位距离（3.3 公里 vs 6.4 公里，p < 0.01）。在符合扫描资格的 1159 名参与者中，451/1159 (38.9%) 的 LLPv2 仅 >= 2.0%，71/1159 (6.1%) 仅 PLCOM2012 >= 1.5%； 637/1159 (55.0%) 满足两个风险阈值。召回率为 15.9%。 29/1145 (2.5 %) 名扫描参与者检测出肺癌（第 1 阶段，58.6 %）； 5/29 患有肺癌的参与者未达到 >= 1.51 % 的 PLCOM2012 阈值；所有患者的 LLPv2 >= 2.0 %。结论：靶向筛查对于检测早期肺癌是有效的。移动和固定站点扫描仪上的参与者吸收水平相似，表明吸收是由扫描仪位置之外的因素驱动的。 LLPv2 模型更加宽松；仅使用 PLCOM2012 进行招募就会漏掉几种癌症。
Objectives: The West London lung screening pilot aimed to identify early-stage lung cancer by targeting low-dose CT (LDCT) to high risk participants. Successful implementation of screening requires maximising participant uptake and identifying those at highest risk. As well as reporting pre-specified baseline screening metrics, additional objectives were to 1) compare participant uptake between a mobile and hospital-based CT scanner and 2) evaluate the impact on cancer detection using two lung cancer risk models.Methods: From primary care records, ever-smokers aged 60-75 were invited to a lung health check at a hospital or mobile site. Participants with PLCOM2012 6-yr risk >= 1.51 % and/or LLPv2 5-yr risk >= 2.0 % were offered a LDCT. Lung cancer detection rate, stage, and recall rates are reported. Participant uptake was compared at both sites (chi-squared test). LDCT eligibility and cancer detection rate were compared between those recruited under each risk model.Results: Of 8366 potential participants invited, 1047/5135 (20.4 %) invitees responded to an invitation to the hospital site, and 702/3231 (21.7 %) to the mobile site (p = 0.14). The median distance travelled to the hospital site was less than to the mobile site (3.3 km vs 6.4 km, p < 0.01). Of 1159 participants eligible for a scan, 451/1159 (38.9 %) had a LLPv2 >= 2.0 % only, 71/1159 (6.1 %) had a PLCOM2012 >= 1.5 % only; 637/1159 (55.0 %) met both risk thresholds. Recall rate was 15.9 %. Lung cancer was detected in 29/1145 (2.5 %) participants scanned (stage 1, 58.6 %); 5/29 participants with lung cancer did not meet a PLCOM2012 threshold of >= 1.51 %; all had a LLPv2 >= 2.0 %.Conclusion: Targeted screening is effective in detecting early-stage lung cancer. Similar levels of participant uptake at a mobile and fixed site scanner were demonstrated, indicating that uptake was driven by factors in addition to scanner location. The LLPv2 model was more permissive; recruitment with PLCOM2012 alone would have missed several cancers.