Open AccessCharacteristics of Singapore lung cancer patients who miss out on lung cancer screening recommendations
Author(s) -
Chee Hong Loh,
Pearly Wenjia Koh,
Daniel Jia Ming Ang,
Wei Chee Lee,
Wui Mei Chew,
Jansen Koh
Publication year - 2022
Publication title -
singapore medical journal/singapore medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.452
H-Index - 61
eISSN - 2737-5935
pISSN - 0037-5675
DOI - 10.11622/smedj.2022039
Subject(s) - medicine , lung cancer , national lung screening trial , lung cancer screening , cohort , cancer , retrospective cohort study , population , lung , stage (stratigraphy) , radiology , paleontology , environmental health , biology
The National Lung Screening Trial (NLST) identified individuals at high risk for lung cancer and showed that serial low-dose helical computer tomographic scans (CT) were able to identify lung cancer at an earlier stage and also demonstrated mortality reduction. However, there has been little evidence regarding the effectiveness of the Lung Cancer Screening Criteria in the Asian population. Methods: To determine lung cancer patients who miss out on Lung Cancer screening criteria, we performed a retrospective audit from January to December 2018 in our hospital, and describe the characteristics of our patients diagnosed with lung cancer. Results: We found that only 38.1% of the patients in our cohort who were diagnosed with lung cancer in 2018 fitted into NLST Criteria strictly by age and smoking criteria. However, those who fitted the inclusion criteria of lung cancer screening would derive significant benefits, as 85.4% presented at advanced stage and 54.6% did not survive one year. We explored using the United States Preventive Services Task Force criteria, which increased sensitivity to 58.7% of identifying our patients with diagnosed lung cancer. 15.5% of females with lung cancer in our cohort fitted into NLST Criteria, but their low smoking quantity is a significant contributing factor for females being excluded. Conclusion: Majority of Singapore patients diagnosed with lung cancer would not have been picked up by NLST Criteria, especially female patients. However, those who fitted the inclusion criteria would derive significant benefit, while expanding to an older limit may yield benefits with improved sensitivity.