Creamer, Andrew W;
Horst, Carolyn;
Dickson, Jennifer L;
Tisi, Sophie;
Hall, Helen;
Verghese, Priyam;
Prendecki, Ruth;
... Janes, Sam M; + view all
(2024)
Stage at Diagnosis Following Delay to Interval Scans for Indeterminate Nodules in Lung Cancer Screening: An Observational Study Examining the Outcomes of CHEST Expert Panel Recommendations.
Chest
, 165
(4)
pp. 1020-1024.
10.1016/j.chest.2023.10.033.
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Abstract
The SARS-CoV-2 pandemic necessitated urgent adaptation of guidelines to ensure individuals were exposed to health care settings only when absolutely necessary. This included the follow-up of pulmonary nodules, especially in lung cancer screening participants. Although delaying imaging follow-up evaluation in this context seems prudent, such delays theoretically risk upstaging of early-stage lung cancers that manifest as nodules. To assist practitioners who facilitate lung cancer screening programs, the CHEST expert panel report recommended that screening should be paused and that, for indeterminate nodules that require surveillance, the time intervals could be relaxed by 3-6 months.// Although the World Health Organization has declared an end to SARS-CoV-2 as a global health emergency, participant adherence to strict timing of interval surveillance scans has been shown to be suboptimal. However, at this time, little is known regarding the effect of such delays on stage at diagnosis.// The SUMMIT Study is a prospective observational cohort study that examines the delivery of a low-dose CT (LDCT) scan lung cancer screening service to a high-risk population and that validates a multicancer early detection blood test. Running from 2019-2023, the study was impacted by national lockdowns caused by the SARS-CoV-2 pandemic, which means that a proportion of participants had delays to interval scans for indeterminate nodules identified on baseline LDCT. The aim of this observational analysis was to examine whether the delay of interval scans for indeterminate nodules within the timescale proposed by the CHEST expert panel was associated with an increased proportion of cancers diagnosed at stage 2 or above.
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