ArticleCancer medicine2021
Evaluating the clinical trends and benefits of low-dose computed tomography in lung cancer patients.
Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Multi-level factors associated with low dose computed tomography lung cancer screening in the United States.Journal of the National Medical Association · 2025Article
- Baseline atrial volume indices and major adverse cardiac events following thoracic radiotherapy.Frontiers in cardiovascular medicine · 2025Article
- Immunotherapy Improves the Survival of Stage 4 Non-Small Cell Lung Cancer Patients at the US Population Level: The Real-World Evidence.The clinical respiratory journal · 2024Article
- Opportunistic Screening With Low-Dose Computed Tomography and Lung Cancer Mortality in China.JAMA network open · 2023Article
- Machine learning in metastatic cancer research: Potentials, possibilities, and prospects.Computational and structural biotechnology journal · 2023Review
- Association Between Primary Care Use Prior to Cancer Diagnosis and Subsequent Cancer Mortality in the Veterans Affairs Health System.JAMA network open · 2022Article
- Evaluating Prostate-Specific Antigen Screening for Young African American Men With Cancer.Journal of the National Cancer Institute · 2022Article
- Evaluating the clinical trends and benefits of low-dose computed tomography in lung cancer patients.Cancer medicine · 2021Article
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11 authors.
Funding
Abstract
backgroundDespite guideline recommendations, utilization of low-dose computed tomography (LDCT) for lung cancer screening remains low. The driving factors behind these low rates and the real-world effect of LDCT utilization on lung cancer outcomes remain limited.
methodsWe identified patients diagnosed with non-small cell lung cancer (NSCLC) from 2015 to 2017 within the Veterans Health Administration. Multivariable logistic regression assessed the influence of LDCT screening on stage at diagnosis. Lead time correction using published LDCT lead times was performed. Cancer-specific mortality (CSM) was evaluated using Fine-Gray regression with non-cancer death as a competing risk. A lasso machine learning model identified important predictors for receiving LDCT screening.
resultsAmong 4664 patients, mean age was 67.8 with 58-month median follow-up, 95% CI = [7-71], and 118 patients received ≥1 screening LDCT before NSCLC diagnosis. From 2015 to 2017, LDCT screening increased (0.1%-6.6%, mean = 1.3%). Compared with no screening, patients with ≥1 LDCT were more than twice as likely to present with stage I disease at diagnosis (odds ratio [OR] 2.16 [95% CI 1.46-3.20]) and less than half as likely to present with stage IV (OR 0.38 [CI 0.21-0.70]). Screened patients had lower risk of CSM even after adjusting for LDCT lead time (subdistribution hazard ratio 0.60 [CI 0.42-0.85]). The machine learning model achieved an area under curve of 0.87 and identified diagnosis year and region as the most important predictors for receiving LDCT. White, non-Hispanic patients were more likely to receive LDCT screening, whereas minority, older, female, and unemployed patients were less likely.
conclusionsUtilization of LDCT screening is increasing, although remains low. Consistent with randomized data, LDCT-screened patients were diagnosed at earlier stages and had lower CSM. LDCT availability appeared to be the main predictor of utilization. Providing access to more patients, including those in diverse racial and socioeconomic groups, should be a priority.
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