Complication rates substantially higher after abnormal findings with low-dose CT lung cancer screening versus those seen in National Lung Screening Trial
By Elana Gotkine HealthDay Reporter
TUESDAY, Jan. 2, 2024 (HealthDay News) — For individuals undergoing low-dose computed tomography (LDCT) scans for lung cancer screening (LCS), the rates of downstream procedures and complications are higher than observed in the National Lung Screening Trial (NLST), according to a study published online Jan. 2 in the Annals of Internal Medicine.
Katharine A. Rendle, Ph.D., M.P.H., from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective cohort study to identify rates of downstream procedures and complications associated with LCS in five U.S. health care systems. Data were included for 9,266 patients who completed a baseline LDCT scan for LCS between 2014 and 2018.
The researchers found that 15.9 percent of the patients had a baseline LDCT scan showing abnormalities, and of these patients, 9.5 percent were diagnosed with lung cancer within 12 months (positive predictive value, 9.5 percent; negative predictive value, 99.8 percent; sensitivity, 92.7 percent; specificity, 84.4 percent). In screened patients, absolute rates of downstream imaging and invasive procedures were 31.9 and 2.8 percent, respectively. Complication rates were substantially higher for those undergoing invasive procedures after abnormal findings than those in the NLST (30.6 versus 17.7 percent for any complication; 20.6 versus 9.4 percent for major complications).
“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 authors write.
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