Early Routine Lung Cancer Screening Leads to Improved Treatment Options and Survival

Abstract

Background

Lung cancer is the second-most common cancer and leading cause of cancer-related deaths. American adults aged 55 to 80 years are at heightened risk for lung cancer; only 4.5% underwent screening history by computed tomography. The hypothesis is that lung cancers diagnosed on screening were an earlier stage which broadens treatment options and improves survival.

Methods

The electronic health record (EHR) was retrospectively queried to identify patients with lung cancer from 2017 to 2020. Kaplan-Maier curves were used to compare survival based on screening history.

Results

764 patients with lung cancer were included. 14.7% (112/764) had a history of lung cancer screening. Patients with a history of screening were significantly more likely to be diagnosed at early stages (66/112, 59% vs 215/652, 33%; P < .0001). They were significantly more likely to have surgery (46/112, 41% vs 97/652, 15%, respectively; P < 0.0001). Patients diagnosed in late stages were significantly more likely than those diagnosed at early stages to receive chemotherapy (318/483, 66% vs 76/281, 27%, respectively; P < .0001). Three-year survival was higher with screening (P < .0001). Survival rates at 3 years after initial diagnosis with screening history is 47.4% (95% CI, 34.8-59.0) while the rate without screening is 25.2% (95% CI, 21.2-29.4).

Discussion

Lung cancer diagnosed via screening was more likely to be earlier stages. Patients diagnosed at early stages were more likely to undergo surgery. Those diagnosed via screening had a higher 3-year survival. These findings indicate that early routine screening leads to improved treatment options and survival.