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Background: There are about 200,000 new cases of lung cancer each year in the U.S. and about 150,000 deaths. Lung cancer is the second most common malignancy but the most common cause of cancer deaths. In 2010, the National Lung Screening Trial described a 20.3% reduction in lung cancer mortality in high-risk patients who were screened by CT scan. In 2012, guidelines were set forth by multiple groups. The National Comprehensive Cancer Network encouraged low-dose CT screening for patients aged 55 to 75 years, ≥ 30 pack-years of smoking, or smoking cessation within 15 years.
Methods: In late 2013, screening was implemented at the Providence VA Medical Center (PVAMC); a rise in the incidence of early stage lung cancer was anticipated. We reviewed the number and stages of cases of non-small cell (NSCLC) and small cell (SCLC) lung cancer in 2012, 2013 (mostly pre-screening), 2014 (screening), and 2015 (4 months of screening).
Results: In 2012 there were 23 cases of NSCLC (5 stage I; 5 stage II; 8 stage III; 2 stage IV; 3 unknown) and 4 cases of SCLC (extensive). In 2013 there were 42 cases of NSCLC (9 stage I; 2 stage II; 10 stage III [1 screened]; 17 stage IV; 4 unknown [1 screened]) and 9 cases of SCLC (1 lim-ited, 8 extensive). In 2014, there were 54 cases of NSCLC (15 stage I [5 screened]; 10 stage II [2 screened]; 11 stage III [3 screened]; 14 stage IV [1 screened]; and 4 unknown) and 5 cases of SCLC (5 extensive). In the first 7 months of 2015, there were 36 cases of NSCLC (13 stage I [10 screened]; 5 stage II [3 screened]; 7 stage III [3 screened]; 8 stage IV [1 screened]; and 3 unknown [1 screened]) and 1 SCLC (extensive) not screened and 1 SCLC (limited) screened.
Discussion: The total number of lung cancer cases has increased with screening (36 in 2012; 51 in 2013; 59 in 2014; 38 in 7 months of 2015). With screening in 2014 there were more cases of late stage disease (NSCLC stage III/IV) than anticipated. In the first 7 months of 2015 72% of screened patients were stage I/II, 22% were stage III/IV, and 6% were unknown. As time progresses and the same patients are screened yearly, the percentage of early stage cases should increase and late stages decrease. It will be worthwhile to reevaluate these data over the next several years.
Background: There are about 200,000 new cases of lung cancer each year in the U.S. and about 150,000 deaths. Lung cancer is the second most common malignancy but the most common cause of cancer deaths. In 2010, the National Lung Screening Trial described a 20.3% reduction in lung cancer mortality in high-risk patients who were screened by CT scan. In 2012, guidelines were set forth by multiple groups. The National Comprehensive Cancer Network encouraged low-dose CT screening for patients aged 55 to 75 years, ≥ 30 pack-years of smoking, or smoking cessation within 15 years.
Methods: In late 2013, screening was implemented at the Providence VA Medical Center (PVAMC); a rise in the incidence of early stage lung cancer was anticipated. We reviewed the number and stages of cases of non-small cell (NSCLC) and small cell (SCLC) lung cancer in 2012, 2013 (mostly pre-screening), 2014 (screening), and 2015 (4 months of screening).
Results: In 2012 there were 23 cases of NSCLC (5 stage I; 5 stage II; 8 stage III; 2 stage IV; 3 unknown) and 4 cases of SCLC (extensive). In 2013 there were 42 cases of NSCLC (9 stage I; 2 stage II; 10 stage III [1 screened]; 17 stage IV; 4 unknown [1 screened]) and 9 cases of SCLC (1 lim-ited, 8 extensive). In 2014, there were 54 cases of NSCLC (15 stage I [5 screened]; 10 stage II [2 screened]; 11 stage III [3 screened]; 14 stage IV [1 screened]; and 4 unknown) and 5 cases of SCLC (5 extensive). In the first 7 months of 2015, there were 36 cases of NSCLC (13 stage I [10 screened]; 5 stage II [3 screened]; 7 stage III [3 screened]; 8 stage IV [1 screened]; and 3 unknown [1 screened]) and 1 SCLC (extensive) not screened and 1 SCLC (limited) screened.
Discussion: The total number of lung cancer cases has increased with screening (36 in 2012; 51 in 2013; 59 in 2014; 38 in 7 months of 2015). With screening in 2014 there were more cases of late stage disease (NSCLC stage III/IV) than anticipated. In the first 7 months of 2015 72% of screened patients were stage I/II, 22% were stage III/IV, and 6% were unknown. As time progresses and the same patients are screened yearly, the percentage of early stage cases should increase and late stages decrease. It will be worthwhile to reevaluate these data over the next several years.
Background: There are about 200,000 new cases of lung cancer each year in the U.S. and about 150,000 deaths. Lung cancer is the second most common malignancy but the most common cause of cancer deaths. In 2010, the National Lung Screening Trial described a 20.3% reduction in lung cancer mortality in high-risk patients who were screened by CT scan. In 2012, guidelines were set forth by multiple groups. The National Comprehensive Cancer Network encouraged low-dose CT screening for patients aged 55 to 75 years, ≥ 30 pack-years of smoking, or smoking cessation within 15 years.
Methods: In late 2013, screening was implemented at the Providence VA Medical Center (PVAMC); a rise in the incidence of early stage lung cancer was anticipated. We reviewed the number and stages of cases of non-small cell (NSCLC) and small cell (SCLC) lung cancer in 2012, 2013 (mostly pre-screening), 2014 (screening), and 2015 (4 months of screening).
Results: In 2012 there were 23 cases of NSCLC (5 stage I; 5 stage II; 8 stage III; 2 stage IV; 3 unknown) and 4 cases of SCLC (extensive). In 2013 there were 42 cases of NSCLC (9 stage I; 2 stage II; 10 stage III [1 screened]; 17 stage IV; 4 unknown [1 screened]) and 9 cases of SCLC (1 lim-ited, 8 extensive). In 2014, there were 54 cases of NSCLC (15 stage I [5 screened]; 10 stage II [2 screened]; 11 stage III [3 screened]; 14 stage IV [1 screened]; and 4 unknown) and 5 cases of SCLC (5 extensive). In the first 7 months of 2015, there were 36 cases of NSCLC (13 stage I [10 screened]; 5 stage II [3 screened]; 7 stage III [3 screened]; 8 stage IV [1 screened]; and 3 unknown [1 screened]) and 1 SCLC (extensive) not screened and 1 SCLC (limited) screened.
Discussion: The total number of lung cancer cases has increased with screening (36 in 2012; 51 in 2013; 59 in 2014; 38 in 7 months of 2015). With screening in 2014 there were more cases of late stage disease (NSCLC stage III/IV) than anticipated. In the first 7 months of 2015 72% of screened patients were stage I/II, 22% were stage III/IV, and 6% were unknown. As time progresses and the same patients are screened yearly, the percentage of early stage cases should increase and late stages decrease. It will be worthwhile to reevaluate these data over the next several years.