TY - JOUR
T1 - Impact of Comorbidities on Lung Cancer Screening Evaluation
AU - Robinson, Eric M.
AU - Liu, Benjamin Y.
AU - Sigel, Keith
AU - Yin, Chung
AU - Wisnivesky, Juan
AU - Kale, Minal S.
N1 - Publisher Copyright:
© 2022
PY - 2022/7
Y1 - 2022/7
N2 - Objectives: : We used data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial to examine the impact of self-reported chronic obstructive pulmonary disease, coronary artery disease, stroke, and diabetes mellitus on diagnostic complications in lung cancer screening evaluation. Methods: : In our analysis, we included individuals from the usual care and intervention (annual chest x-ray) of the lung cancer screening trial with equal or greater than 55 years of age with a 20 pack-year smoking history who had undergone an invasive procedure. We performed multivariate logistic regression analysis to estimate the association of comorbidity on procedure complication. Our primary outcome was the incidence of major or moderate complications. Results: : Features associated with high-risk complication included older age (OR = 1.03 per year, P =.001), history of coronary artery disease (OR = 1.40, P =.03), history of diabetes mellitus (OR = 0.41, P <.001, current smoking status (OR = 1.46, P ≤.001), surgical biopsy (OR = 7.39, P <.001), needle biopsy (OR = 1.94, P <.001), and other invasive procedure (OR = 1.58, P <.001). We did not find an associated with complication and history of stroke (OR = 0.84, P =.53) or chronic obstructive pulmonary disease (OR = 1.27, P =.06). Conclusion: : Patient and procedure-level factors may alter the benefits of lung cancer screening. Data concerning individual risk factors and high-risk complications should therefore be incorporated into diagnostic algorithms to optimize clinical benefit and minimize harm. Further study and validation of the risk factors identified herein are warranted.
AB - Objectives: : We used data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial to examine the impact of self-reported chronic obstructive pulmonary disease, coronary artery disease, stroke, and diabetes mellitus on diagnostic complications in lung cancer screening evaluation. Methods: : In our analysis, we included individuals from the usual care and intervention (annual chest x-ray) of the lung cancer screening trial with equal or greater than 55 years of age with a 20 pack-year smoking history who had undergone an invasive procedure. We performed multivariate logistic regression analysis to estimate the association of comorbidity on procedure complication. Our primary outcome was the incidence of major or moderate complications. Results: : Features associated with high-risk complication included older age (OR = 1.03 per year, P =.001), history of coronary artery disease (OR = 1.40, P =.03), history of diabetes mellitus (OR = 0.41, P <.001, current smoking status (OR = 1.46, P ≤.001), surgical biopsy (OR = 7.39, P <.001), needle biopsy (OR = 1.94, P <.001), and other invasive procedure (OR = 1.58, P <.001). We did not find an associated with complication and history of stroke (OR = 0.84, P =.53) or chronic obstructive pulmonary disease (OR = 1.27, P =.06). Conclusion: : Patient and procedure-level factors may alter the benefits of lung cancer screening. Data concerning individual risk factors and high-risk complications should therefore be incorporated into diagnostic algorithms to optimize clinical benefit and minimize harm. Further study and validation of the risk factors identified herein are warranted.
KW - Biopsy
KW - Comorbidities
KW - Diagnostic screening programs
KW - Early detection of cancer
KW - Lung Cancer Screening
KW - Lung neoplasms
UR - http://www.scopus.com/inward/record.url?scp=85131097701&partnerID=8YFLogxK
U2 - 10.1016/j.cllc.2022.03.012
DO - 10.1016/j.cllc.2022.03.012
M3 - Article
AN - SCOPUS:85131097701
SN - 1525-7304
VL - 23
SP - 402
EP - 409
JO - Clinical Lung Cancer
JF - Clinical Lung Cancer
IS - 5
ER -