Brady John McKee MD, Presenter: Nothing to Disclose

Jeffrey Alexander Hashim MD, Abstract Co-Author: Nothing to Disclose

Robert James French MD, Abstract Co-Author: Nothing to Disclose

Andrea Bertram McKee MD, Abstract Co-Author: Nothing to Disclose

Christoph Wald MD, PhD, Abstract Co-Author: Radiology Advisory Committee, Koninklijke Philips NV

Sebastian Flacke MD, Abstract Co-Author: Research Consultant, Pluromed, Inc Speaker, Nordion, Inc

To compare the demographic characteristics and screening results of NCCN high-risk Group 2 (>50y, >20 pack-years, 1 additional risk factor) to NCCN high-risk Group 1 (55-74y, current or former smoker quit 30 pack-years) in a clinical CT lung screening program.

We retrospectively reviewed results of all CT lung screening exams performed from 1/2012 through 12/2013. Those screened had to fulfill the NCCN high-risk criteria and have an MD order for screening. All exams were performed on 64+ MDCT scanners at 100 kV and 30-70 mA. Image interpretation was performed by credentialed radiologists using the structured reporting system, “LungRADS”. A positive exam was defined as a solid nodule > 4mm, a groundglass nodule > 5mm, or a chest lymph node > 1 cm not stable for more than two years. Clinically significant incidental findings including findings suspicious for pulmonary infection were recorded.

458 Group 2 and 1302 Group 1 individuals underwent prevalence CT lung screening exams during the study interval. Group 2 qualifying risk factors: 44% personal history of smoking related cancer, 28% chronic lung disease, 24% carcinogen exposure, < 5% primary relative w/lung cancer. Male/female ratio, average age, and average pack-years was 50/50, 61, and 40 for Group 2 and 53/47, 63, and 50 for Group 1. 36% of Group 2 and 50% of Group 1 were active smokers. Average duration of smoking cessation was 18.5y in Group 2, 6.7y in Group 1. 25% in Group 2 and 28% in Group 1 had positive exams. 6.1 % in Group 2 and Group 1 had at least one clinically significant incidental finding. 6.1% in Group 2 and 6.6 % in Group 1 had findings suspicious for pulmonary infection. 23 cases of lung cancer were diagnosed in 1328/1760 (75%) with clinical followup after screening: 6 in Group 2 and 17 in Group 1 with an annualized rate of malignancy of 1.6% for Group 1 and 1.8% for Group 2.

Screening results for NCCN Group 2 are similar to NCCN Group 1 and those reported in the National Lung Screening Trial. The prevalence rate of lung cancer in NCCN Group 2 suggests thousand of additional lives could be saved each year if screening eligibility is expanded to include this high-risk group.

Expanding CT lung screening eligibility to include NCCN high-risk Group 2 could increase the number of qualified Americans by two to three million and offers the potential to save thousands of additional lives each year.

McKee, B, Hashim, J, French, R, McKee, A, Wald, C, Flacke, S, Invited Speaker: Demographic Characteristics and Results of National Comprehensive Cancer Network High-risk Group 2 in a Clinical CT Lung Screening Program.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002308.html