接受心脏胸部CT的患者的肺癌风险：识别肺癌筛查的新高危人群
Lung Cancer Risk for Patients Undergoing Cardiac Chest CT: Identification of a New High Risk Population for Lung Cancer Screening.
作者
作者单位
- Department of Cardiothoracic Surgery, Stanford University Medical Center. Electronic address: ltsai2@stanford.edu.
- Department of Cardiothoracic Surgery, Stanford University Medical Center.
- Research Technology, Technology & Digital Solutions, Stanford Health Care.
- Quantitative Sciences Unit, Department of Medicine, Stanford Cancer Institute, Stanford University School of Medicine.
- Department of Cardiothoracic Surgery, Stanford University Medical Center; Veterans Affairs Healthcare System, Palo Alto.
摘要
中文
尽管资格标准扩大，肺癌筛查（LCS）率仍然很低。许多接受心脏CT扫描的患者也可能有肺癌风险因素。我们旨在通过量化这一人群来识别增加LCS的机会。我们医疗系统从2011年1月至2023年12月所有接受CT心脏或CT血管造影心脏的患者均被纳入。评估了该人群中的肺癌发病率。LCS资格由USPSTF指南确定。共有31,684名患者接受了心脏CT扫描，其中17,232名患者符合研究标准（有记录的吸烟史，年龄50-80岁，无既往肺癌诊断）。根据2021年USPSTF指南，114名（0.7%）患者符合LCS资格，而我们医疗系统中所有患者中这一比例为0.37%。共有73名接受心脏CT的患者发展为肺癌诊断。在符合LCS资格的患者中，1名（0.8%）发展为肺癌，7名（6.1%）接受了低剂量CT，21名（18.4%）接受了诊断性胸部CT。另外72名（0.4%）接受心脏CT的患者在中位19.8（5.7，51.7）个月后被诊断为肺癌，但不符合LCS资格。接受心脏CT扫描的患者中肺癌诊断风险显著高于一般人群。然而，这些患者中的大多数不符合LCS资格。在这一人群中倡导更完整的胸部成像可能有助于识别肺癌以进行早期干预。
English
Lung cancer screening (LCS) rates are low despite expanded eligibility criteria. Many patients receiving cardiac CT scans may also have risk factors for lung cancer. We aimed to identify an opportunity to increase LCS by quantifying this population. All patients in our healthcare system from January 2011 to December 2023 who received a CT heart or CT angiogram heart were included. Lung cancer rates in this population were assessed. LCS eligibility was determined by USPSTF guidelines. A total of 31,684 patients received cardiac CT scans and 17,232 patients met the study criteria (documented smoking history, age 50-80 years, no prior diagnosis of lung cancer). Based on 2021 USPSTF guidelines, 114 (0.7%) patients were eligible for LCS compared to 0.37% of all patients in our healthcare system. A total of 73 patients undergoing cardiac CT developed a diagnosis of lung cancer. Among those meeting LCS eligibility, 1 (0.8%) developed lung cancer, 7 (6.1%) received a low dose CT, and 21 (18.4%) received a diagnostic chest CT. An additional 72 (0.4%) patients of patients who received a cardiac CT were subsequently diagnosed with lung cancer at a median of 19.8 (5.7, 51.7) months, yet did not meet LCS eligibility. Risk of lung cancer diagnosis among patients receiving cardiac CT scan is significantly higher than that of the general population. However, most of these patients did not qualify for LCS. Advocacy for more complete chest imaging in this population may facilitate identification of lung cancer for early intervention.
分类与指标
- 研究类型
- 临床研究
- 病种
- 肺癌
- JCR 分区
- Q1
- 影响因子
- 5.3