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- W2898254312 abstract "Low-dose computed tomography lung cancer screening is recommended by US guidelines. New solid nodules are regularly found in incidence screening rounds and have a higher lung cancer probability than baseline nodules. Contrary to baseline nodules, new nodules develop within a known screening interval (time between previous screen and new nodule detection). There is limited evidence concerning the impact of varying screening interval lengths on new solid nodules. In the randomized Dutch-Belgian Lung Cancer Screening (NELSON) Trial, 7,557 participants underwent baseline screening. Three incidence rounds took place after intervals of 12months, 24months and 30months respectively and follow-up intervals ranged from 2-12months. We included solid non-calcified nodules registered after baseline as new and not visible in retrospect. Using logistic regression, screening interval length was assessed as predictor for lung cancer whilst adjusting for nodule size. The correlation of screening interval length and new nodule size was assessed with Spearman's rank correlation. Discriminative performance for lung cancer was quantified as area under the receiver operating characteristics curve (AUC). Overall, 1,130 new solid nodules were included with 6% being lung cancer. Of the nodules, 13% were detected after a screening interval of <10months, 28% after 10-14months, 4% after 15-21months, 37% after 22-26months, and 20% after >26months. While the proportion of new solid nodules that subsequently resolved until first follow-up decreased with longer screening interval (76%, 70%, 59%, 57%, 41% respectively, p<0.001), the lung cancer proportion significantly increased (2%, 3%, 3%, 7%, 11% respectively, p=0.001). The screening interval length was a significant predictor for lung cancer when assessed in all nodules (p=0.018). However, there was no significant association when only assessed in nodules that persisted on first follow-up (p=0.223). Compared to benign nodules, lung cancer size at initial detection correlated stronger with screening interval length (spearman's rho 0.106 vs. 0.320) and the discriminative performance of volume for lung cancer increased with screening interval length (AUC: 0.71 at 10-14months vs. 0.84 at >26months). Comparing malignant nodules detected after 10-14months, 22-26months or >26months, the proportion of stage IA lung cancers decreased (73%, 63%, 39% respectively, p=0.139) and all IIIb/IV cancers were found after >22months. The longer the screening interval prior to new nodule detection, the lower the nodule’s probability to resolve and the higher the nodule’s lung cancer probability. While a longer screening interval might facilitate the discrimination between benign and malignant new solid nodules, there was a trend for less favorable staging." @default.
- W2898254312 created "2018-11-02" @default.
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- W2898254312 date "2018-10-01" @default.
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- W2898254312 title "P2.11-24 Impact of Screening Interval Length on New Nodules Detected in Incidence Rounds of CT Lung Cancer Screening: the NELSON Trial" @default.
- W2898254312 doi "https://doi.org/10.1016/j.jtho.2018.08.1371" @default.
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