Invasive Procedures and Complications Follow Lung Cancer Screening

 

TOPLINE:

After lung cancer screening (LCS), imaging and invasive procedures were performed 31.9% and 2.8% of the time, respectively. Complications during invasive procedures occurred in 30.6% of cases. 

METHODOLOGY:

• Researchers analyzed data from 9266 patients aged 55-80 years who completed at least one LCS with low-dose CT (LDCT) between 2014 and 2018.
• This study used data from the PROSPR Lung Consortium.
• Results were compared with findings from the National Lung Screening Trial (NLST), a large study of smokers published in 2011.

TAKEAWAY:

• In total, 2956 patients (31.9%) underwent follow-up imaging, including CT, LDCT, MRI, or PET; 180 (0.02%) had invasive procedures, including needle biopsy, bronchoscopy, mediastinoscopy or mediastinotomy, or thoracoscopy.
• Within 30 days after an invasive diagnostic procedure, 55 of 180 patients (30.6%) experienced complications; 20.6% were major, 8.3% were intermediate, and 1.7% were minor.
• Complication rates after invasive procedures were higher in PROSPR than the NLST (30.6% vs 17.7%).
• Compared with all patients, those with an abnormal LCS were slightly older, more likely to currently smoke, reported more packs of cigarettes smoked daily, and had more comorbid conditions.
• In 2013, the US Preventive Services Task Force recommended annual LCS for certain people who smoke, on the basis of findings from the NLST.

IN PRACTICE:

"We observed higher rates of both invasive procedures and complications than those observed in NLST, highlighting the need for practice-based strategies to assess variations in the quality of care and to prioritize LCS among those patients most likely to receive a net benefit from screening in relation to potential complications and other harms," the researchers wrote. 

SOURCE:

Katharine A. Rendle, PhD, MSW, MPH, with Perelman School of Medicine, University of Pennsylvania, is the study's corresponding author. The study was published online in Annals of Internal Medicine.

LIMITATIONS:

This study was retrospective, and data were analyzed using procedural coding. In addition, the NLST based abnormal findings on different criteria from those used in clinical practice (Lung-RADS), making direct comparison of patients difficult. Patients in PROSPR were older, more likely to be currently smoking, and had higher rates of comorbid conditions compared with patients in the NLST. 

DISCLOSURES:

This study was supported by grants from the National Cancer Institute and the Gordon and Betty Moore Foundation.

https://www.medscape.com/viewarticle/invasive-procedures-and-complications-follow-lung-cancer-2024a10000oi