A 'disconcerting' number of patients at high risk of lung cancer put off follow-up care
Up to 47% of patients at high risk of lung cancer after CT screening drag their feet before seeking follow-up care.
That’s according to research presented May 17 at the American Thoracic Society’s 2022 international conference in San Francisco. The study analyzed nearly 400 patients in a Seattle-based lung cancer screening program to understand how patients whose baseline imaging classified them as high risk would respond to such findings. The results of the analysis were cause for concern among researchers involved in the study.
Regarding the results, the study’s presenting author, Alwiya Ahmed, MD, MPH, internal medicine resident at the University of Washington School of Medicine and physician-scientist at the Seattle Cancer Care Alliance and Fred Hutchinson Cancer Research Center, commented:
“Previous studies have shown that participation in lung cancer screening is low relative to other types of screening such as mammography and colorectal cancer screening, but this may be due in part to the fact that lung cancer screening is a relatively new service. Nonetheless, it is disconcerting to see that among those screened who have abnormal findings, there is a significant delay in recommended follow-up. This could ultimately result in delayed diagnosis of lung cancer.”
Individuals whose imaging was included in the study were divided into four groups—Lung-RADS 3, 4A, 4B or 4X—based on their ACR Lung-RADS assessments. Patients who did not complete follow-up care, defined as “CT, other appropriate imaging, specialty consultation or procedure,” within 30 days of the recommended time were considered delayed. Those with very suspicious findings were recommended to follow up within 30 days.
Of the 397 patients who had high risk findings, 59 were diagnosed with lung cancer. Follow-up was delayed in 47% of these exams, with a median delay of 91 days. Current smokers were more likely to put off follow-up care, the authors noted.
“There has been quite a bit of work to understand and improve long-term maintenance for people with normal screening exams, but little research on abnormal findings. Given the likely impact of a delay in diagnosis, we are hopeful that our study will spur additional research in this area,” Ahmed said.
The American Thoracic Society’s study abstract can be viewed here.
Related lung cancer screening research:
Q&A: What updated reimbursement policies could mean for CT lung screening rates in the United States
Lung cancer risk increases with emphysema severity
ACR outlines changes in Medicare lung cancer screening coverage
Stratifying patients by risk of poor outcomes could reduce overtreatment of lung cancer
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.